| NPI | 1982964128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA CLARKE CEO 773-995-1587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2012-05-22 |