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Organization
HOLISTIC FAMILY MEDICINE
Active
Organization
HOLISTIC FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY JENKINS (OFFICE MANAGER)
(312) 953-0547
Entity
Organization
Contact information
Practice address
11110 S SAWYER AVE, CHICAGO, IL 60655-2724
(773) 881-7191
Mailing address
1647 W 105TH PL, CHICAGO, IL 60643-2915
(773) 881-7191
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036094988
IL
Other
Enumeration date
08/28/2008
Last updated
08/28/2008
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