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Organization
NORTHWEST MEDICAL AND URGENT CARE CENTER AT YALE AND 95TH LTD
Active
Organization
NORTHWEST MEDICAL AND URGENT CARE CENTER AT YALE AND 95TH LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD KHAMIS MD (PRESIDENT)
(773) 468-2110
Entity
Organization
Contact information
Practice address
237 W 95TH ST, CHICAGO, IL 60628-1321
(773) 468-2110
(773) 468-2109
Mailing address
5352 N LINCOLN AVE, CHICAGO, IL 60625-2316
(773) 353-5047
(773) 353-2406
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036112029
—
IL
Enumeration date
11/13/2017
Last updated
10/24/2018
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