SOUTHSIDE FAMILY MEDICINE PC

CHICAGO, IL
NPI1922361450
Entity TypeOrganization
Authorized ContactCARLOS J. CRUDUP
President
773-667-5577
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IL  336.073573)
Enumeration Date2012-06-19
Last Update Date2012-06-19
Business Address
SOUTHSIDE FAMILY MEDICINE PC
1525 E 55TH ST SUITE 307
CHICAGO, IL 60615-5512
Phone number: 773-667-5577
Mailing Address
SOUTHSIDE FAMILY MEDICINE PC
1446 E 63RD ST
CHICAGO, IL 60637-2948
Phone number: 773-230-2741
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