COOK COUNTY

NPI # 

Practice Address:

4859 S Wabash Ave

Chicago, IL, 60615-1008

Practice Phone:

773-268-4305

License Number:

0004549

License State:

IL

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Student Health

Taxonomy Code:

261QS1000X