COOK COUNTY
Organization (NPI-2)
Active
Clinic/Center, Primary Care
Provider Information
- NPI Number
1104946904- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 2423 S AUSTIN BLVD, CICERO, IL, 608042616
- Phone
- (708) 656-1130
Specialties & Taxonomies
Clinic/Center, Primary Care
Primary License: IL #0005272