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Organization
SALAAM COMMUNITY WELLNESS CENTER
Active
Organization
SALAAM COMMUNITY WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONSTANCE DIANE SHABAZZ MD (CEO)
(773) 330-4115
Entity
Organization
Contact information
Practice address
613 E 67TH ST, CHICAGO, IL 60637-4122
(773) 207-3540
Mailing address
18613 JANA PATRICE DR, PFLUGERVILLE, TX 78660-7584
(773) 330-4115
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
NULL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
05/07/2021
Last updated
05/03/2022
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