# CITY OF CHICAGO

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Chicago Department of Public Health South Austin
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427322155
- **Authorized official:** MR. ANTONIO BELTRAN (FIRST DEPUTY COMMISSIONER)
- **Authorized official phone:** (312) 747-9878

## Contact information

- **Practice address:** 4958 W MADISON ST, CHICAGO, IL 60644-3541
- **Practice address phone:** (312) 746-4871
- **Practice address fax:** (312) 746-4637
- **Mailing address:** 4958 W MADISON ST, CHICAGO, IL 60644-3541
- **Mailing address phone:** (312) 746-4871
- **Mailing address fax:** (312) 746-4637

## Taxonomy

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

## Other

- **Enumeration date:** 02/27/2012
- **Last updated:** 02/27/2012