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Organization
FULLERTON OCCUPATIONAL MEDICINE & IMMEDIATE CARE SC
Active
Organization
FULLERTON OCCUPATIONAL MEDICINE & IMMEDIATE CARE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENLIN XIA MD (PRESIDENT)
(773) 486-5001
Entity
Organization
Contact information
Practice address
3409 W FULLERTON AVE, CHICAGO, IL 60647-2415
(773) 486-5001
Mailing address
3409 W FULLERTON AVE, CHICAGO, IL 60647-2415
(773) 486-5001
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
364061160
IL
261QU0200X
Urgent Care Clinic/Center
364061160
IL
261QX0100X
Occupational Medicine Clinic/Center
Primary
364061160
IL
Other
Enumeration date
03/16/2007
Last updated
04/13/2010
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