# CORNELL ABRAXAS MIDWEST

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CORNELL ABRAXAS GROUP, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1669798526
- **Legal business name:** CORNELL ABRAXAS GROUP, INC
- **Authorized official:** MS. INEZ C FERRANTE MBA (BUSINESS MANAGER)
- **Authorized official phone:** (419) 747-0819

## Contact information

- **Practice address:** 2221 64TH ST, WOODRIDGE, IL 60517-2180
- **Practice address phone:** (630) 968-6477
- **Mailing address:** 2221 64TH ST, WOODRIDGE, IL 60517-2180
- **Mailing address phone:** (630) 968-6477

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/15/2010
- **Last updated:** 04/15/2010