| 63rd Advanced Health Clinic Inc | |
|
1249 W 63rd St Chicago IL 60636-1947 | |
| (847) 904-7500 | |
| (847) 904-7502 |
| Full Name | 63rd Advanced Health Clinic Inc |
|---|---|
| Speciality | Family Medicine - Adolescent Medicine |
| Location | 1249 W 63rd St, Chicago, Illinois |
| Authorized Official Name and Position | Alesia Chaika (OWNER) |
| Authorized Official Contact | 8479047500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 63rd Advanced Health Clinic Inc 1249 W 63rd St Chicago IL 60636-1947 Ph: (847) 904-7500 | 63rd Advanced Health Clinic Inc 1249 W 63rd St Chicago IL 60636-1947 Ph: (847) 904-7500 |
| NPI Number | 1548492234 |
|---|---|
| Provider Enumeration Date | 08/14/2009 |
| Last Update Date | 08/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548492234 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0000X | Family Medicine - Adolescent Medicine | (* (Not Available)) | Primary |
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