| National Teachers Academy Clinic | |
|
55 W Cermak Rd Chicago IL 60616-2001 | |
| (312) 996-2000 | |
| (312) 413-1782 |
| Full Name | National Teachers Academy Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 55 W Cermak Rd, Chicago, Illinois |
| Authorized Official Name and Position | Henry Taylor (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3124131261 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| National Teachers Academy Clinic 2045 W Washington Blvd M/c 698 Chicago IL 60612-2428 Ph: (312) 996-2000 | National Teachers Academy Clinic 55 W Cermak Rd Chicago IL 60616-2001 Ph: (312) 996-2000 |
| NPI Number | 1356367304 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 12/10/2015 |
| Medicare PECOS PAC ID | 3072422716 |
|---|---|
| Medicare Enrollment ID | O20141027001730 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356367304 | NPI | - | NPPES |
| 1622185 | Other | BCBS PROVIDER ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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