| NPI | 1962525691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN BAUER Executive Director 312-795-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2015-10-30 |