# ST. BERNARD HOSPITAL AMBULATORY CARE CLINIC

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

## Provider details

- **NPI number:** 1275068876
- **Authorized official:** MS. BIAISHA YUTRINA WASHINGTON NP-C (ADVANCED NURSE PRACTITIONER)
- **Authorized official phone:** (773) 962-3975

## Contact information

- **Practice address:** 6307 S STEWART, CHICAGO, IL 60621
- **Practice address phone:** (773) 962-3975
- **Practice address fax:** (773) 962-4252
- **Mailing address:** 7634 S PRAIRIE AVE, CHICAGO, IL 60619-2418
- **Mailing address phone:** (773) 962-3975
- **Mailing address fax:** (773) 962-4252

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 209.015904 | IL | Yes |

## Other

- **Enumeration date:** 04/21/2017
- **Last updated:** 05/03/2017