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 |