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Organization
QUALITY PRIMARY CARE PC
Active
Organization
QUALITY PRIMARY CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIVA LUBIN JOHNSON MD (CEO)
(773) 488-2200
Entity
Organization
Contact information
Practice address
8541 S STATE ST, CHICAGO, IL 60619-5665
(773) 488-2200
Mailing address
8541 S STATE ST, CHICAGO, IL 60619-5665
(773) 488-2200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700839719
MEDICARE
IL
Enumeration date
05/19/2006
Last updated
01/02/2013
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