Mamanatandathernizampc
Mamanatandathernizampc is a Community Health Clinic/Center in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2010.
- Licensed in
- IL
- In the registry since
- 2010
Practice location Address checks out
2001 W.69THSTChicago, IL 60636
Phone: (773) 778-2355
Fax: (773) 788-2355
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Community Health Clinic/Center (primary) | Taxonomy 261QC1500X · Licence 036-06-9635 (IL) |
|---|
Record details
| NPI number | 1104134915 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Maimanat Nizam — Physician · (630) 654-1021 |
| NPI enumerated | September 15, 2010 |
| Last updated in NPPES | September 15, 2010 |
| Mailing address | 401 Tamerton Pkwy, Burr Ridge, IL 60527-6347 |
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