| Mercy Phillips Health Center | |
|
244 E Pershing Rd Chicago IL 60653-2222 | |
| (312) 567-7058 | |
| (312) 328-7982 |
| Full Name | Mercy Phillips Health Center |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 244 E Pershing Rd, Chicago, Illinois |
| Authorized Official Name and Position | Patrice Kathleen Griffin (DELEGATED OFFICIAL) |
| Authorized Official Contact | 3125675593 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Phillips Health Center 244 E Pershing Rd Chicago IL 60653-2222 Ph: (312) 567-7058 | Mercy Phillips Health Center 244 E Pershing Rd Chicago IL 60653-2222 Ph: (312) 567-7058 |
| NPI Number | 1730310251 |
|---|---|
| Provider Enumeration Date | 07/31/2009 |
| Last Update Date | 07/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730310251 | NPI | - | NPPES |
| 771115016 | Other | IL | DHS |
| 14D1036279 | Other | IL | CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | 0001578 (Illinois) | Primary |
| 291U00000X | Clinical Medical Laboratory | 771115016 (Illinois) | Secondary |
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