| NPI | 1932395233 |
|---|---|
| Doing Business As | MILE SQUARE - IHC THRESHOLDS NORTH |
| Entity Type | Organization |
| Authorized Contact | WILLIAM R. NICHOLAS Executive Director Medical Plan Uic 312-413-0573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2009-07-22 |