| Central Campus Specialty Care Clinic | |
|
1901 W Harrison St Chicago IL 60612-3714 | |
| (312) 864-4649 | |
| Not Available |
| Full Name | Central Campus Specialty Care Clinic |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1901 W Harrison St, Chicago, Illinois |
| Authorized Official Name and Position | Scott Andrle (DIRECTOR MANAGED CARE) |
| Authorized Official Contact | 3128644649 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Campus Specialty Care Clinic 1900 W Polk St Ste 220c Chicago IL 60612-3723 Ph: (312) 864-4649 | Central Campus Specialty Care Clinic 1901 W Harrison St Chicago IL 60612-3714 Ph: (312) 864-4649 |
| NPI Number | 1245350040 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 06/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245350040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 0005272 (Illinois) | Primary |
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