| NPI | 1922695949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKISA DAVIS Com 773-389-1899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 374J00000X Doula | |
| Enumeration Date | 2020-12-23 |
| Last Update Date | 2022-06-11 |