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Organization
MICHIGAN AVENUE PRIMARY CARE, S.C.
Active
Organization
MICHIGAN AVENUE PRIMARY CARE, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES A RUNKE MD (MEDICAL DIRECTOR)
(312) 201-1234
Entity
Organization
Contact information
Practice address
180 N MICHIGAN AVE, SUITE 1605, CHICAGO, IL 60601-7478
(312) 201-1234
(312) 201-1202
Mailing address
180 N MICHIGAN AVE, SUITE 1605, CHICAGO, IL 60601-7478
(312) 201-1234
(312) 201-1202
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
02/24/2010
Last updated
01/22/2013
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