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Contact Information

CHICAGO MONTICELLO MEDICAL CTR
3623 W CHICAGO AVE
CHICAGO, IL60651-3934
 Phone: 773-722-6171
 Fax: 773-722-7913
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Non-Pharmacy Dispensing Site

332900000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for CHICAGO MONTICELLO MEDICAL CTR

NPI # 1447265053
LBN Legal business name CHICAGO MONTICELLO MEDICAL CTR
Authorized official MICHAEL EARLEY - (MD)
Entity Organization
Organization subpart 1 No
Enumeration date 07/30/2006
Last updated 11/19/2007 - About 19 years ago
Identifiers
Other 1478723 OTHER ID NUMBER
Other 1478723 OTHER ID NUMBER-COMMERCIAL NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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