| Chicago Medical Center,sc | |
|
4112 N Lincoln Ave Chicago IL 60618-3028 | |
| (773) 248-0300 | |
| (773) 248-0303 |
| Full Name | Chicago Medical Center,sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4112 N Lincoln Ave, Chicago, Illinois |
| Authorized Official Name and Position | Andra Munteanu (PRACTICE OWNER) |
| Authorized Official Contact | 7732480300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Medical Center,sc Po Box 597781 Chicago IL 60659-7781 Ph: (773) 248-0300 | Chicago Medical Center,sc 4112 N Lincoln Ave Chicago IL 60618-3028 Ph: (773) 248-0300 |
| NPI Number | 1174710255 |
|---|---|
| Provider Enumeration Date | 10/02/2007 |
| Last Update Date | 10/12/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174710255 | NPI | - | NPPES |
| 03609939 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Illinois) | Primary |
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