# TARGET CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023448644
- **Authorized official:** ELIZABETH MARIE JACOBSMA APN, FNP-C (NURSE PRACTITIONER)
- **Authorized official phone:** (563) 505-3837

## Contact information

- **Practice address:** 1154 S CLARK ST, CHICAGO, IL 60605-2159
- **Practice address phone:** (312) 212-6300
- **Mailing address:** 4733 N CLARK ST, APT 2N, CHICAGO, IL 60640-7555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 209010998 | IL | Yes |

## Other

- **Enumeration date:** 11/18/2013
- **Last updated:** 11/19/2013