# CHICAGO FAMILY MEDICAL CENTER INC

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

## Provider details

- **NPI number:** 1396155669
- **Authorized official:** MOHAMMED RIAZUDDIN MD (PRESIDENT)
- **Authorized official phone:** (630) 495-3333

## Contact information

- **Practice address:** 1512 W CHICAGO AVE, SUITE 1, CHICAGO, IL 60642-5204
- **Practice address phone:** (630) 495-3333
- **Mailing address:** 1512 W CHICAGO AVE, SUITE 1, CHICAGO, IL 60642-5204
- **Mailing address phone:** (630) 495-3333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 036065312 | IL | Yes |

## Other

- **Enumeration date:** 05/07/2014
- **Last updated:** 05/07/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1588755409 | NPI | IL |