COOK COUNTY

NPI # 

Practice Address:

5501 W. Fullerton Ave

Chicago, IL, 60639

Practice Phone:

312-395-7400

License Number:

0005272

License State:

IL

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Primary Care

Taxonomy Code:

261QP2300X