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Organization
THE CHICAGO WEIGHT LOSS CENTER, LLC
Active
Organization
THE CHICAGO WEIGHT LOSS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE BRANSFORD (MBR)
(210) 632-8028
Entity
Organization
Contact information
Practice address
2731 N LINCOLN AVE, CHICAGO, IL 60614-1320
(210) 632-8028
Mailing address
945 W HURON ST UNIT 4W, CHICAGO, IL 60642-6297
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
164005482
IL
207R00000X
Internal Medicine Physician
Primary
036128168
IL
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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