CITY OF CHICAGO

NPI # 

Practice Address:

2418 W Division St

Chicago, IL, 60622-2940

Practice Phone:

312-744-0943

Practice Fax:

312-744-5516

License State:

IL

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Community Health

Taxonomy Code:

261QC1500X