Smg Antillas Family Medical Center | |
3111 W Armitage Ave Chicago IL 60647-3818 | |
(773) 394-5260 | |
(773) 394-5271 |
Full Name | Smg Antillas Family Medical Center |
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Speciality | Family Medicine |
Location | 3111 W Armitage Ave, Chicago, Illinois |
Authorized Official Name and Position | John E Vazquez (CMO) |
Authorized Official Contact | 7732576850 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Smg Antillas Family Medical Center 1501 S California Ave Chicago IL 60608-1732 Ph: (708) 786-2905 | Smg Antillas Family Medical Center 3111 W Armitage Ave Chicago IL 60647-3818 Ph: (773) 394-5260 |
NPI Number | 1144383084 |
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Provider Enumeration Date | 12/19/2006 |
Last Update Date | 06/18/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144383084 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 036048103 (Illinois) | Primary |
207R00000X | Internal Medicine | 036045280 (Illinois) | Secondary |
208000000X | Pediatrics | 036055442 (Illinois) | Secondary |
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