| Jlm Abundant Life Community Center | |
|
2622 W Jackson Blvd Chicago IL 60612-2807 | |
| (773) 733-5301 | |
| Not Available |
| Full Name | Jlm Abundant Life Community Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2622 W Jackson Blvd, Chicago, Illinois |
| Authorized Official Name and Position | Johnny L Miller (CEO) |
| Authorized Official Contact | 7737335301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jlm Abundant Life Community Center 2622 W Jackson Blvd Chicago IL 60612-2807 Ph: () - | Jlm Abundant Life Community Center 2622 W Jackson Blvd Chicago IL 60612-2807 Ph: (773) 733-5301 |
| NPI Number | 1164658415 |
|---|---|
| Provider Enumeration Date | 06/01/2009 |
| Last Update Date | 06/01/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164658415 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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