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NPI Profile for 63RD ADVANCED HEALTH CLINIC INC in CHICAGO, IL.
A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adolescent Medicine |
207QA0000X | 08 | Physician/Family Practice |
| NPI Number | 1548492234 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 08/14/2009 | |
| Last updated | 08/14/2009 - About 17 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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63RD ADVANCED HEALTH CLINIC INC
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63RD ADVANCED HEALTH CLINIC INC