| Infant Jesus Llc | |
|
5137 W Chicago Ave Chicago IL 60651-2904 | |
| (773) 378-4664 | |
| (773) 378-5739 |
| Full Name | Infant Jesus Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 5137 W Chicago Ave, Chicago, Illinois |
| Authorized Official Name and Position | Chandra Mohini Khurana (CEO) |
| Authorized Official Contact | 7738371550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Infant Jesus Llc 5137 W Chicago Ave Chicago IL 60651-2904 Ph: (773) 378-4664 | Infant Jesus Llc 5137 W Chicago Ave Chicago IL 60651-2904 Ph: (773) 378-4664 |
| NPI Number | 1649674235 |
|---|---|
| Provider Enumeration Date | 10/10/2014 |
| Last Update Date | 10/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649674235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Illinois) | Primary |
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