COOK COUNTY

NPI # 

Practice Address:

4600 W Chicago Ave

Chicago, IL, 60651-3342

Practice Phone:

773-826-9600

License Number:

000572

License State:

IL

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Primary Care

Taxonomy Code:

261QP2300X