# 31ST STD CLINIC

> 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
- **Other names:** 31st Street Sexually Transmitted Diseases
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821159625
- **Authorized official:** SARAI M JACKSON DIRECTOR (DIRECTOR OF REVENUE)
- **Authorized official phone:** (312) 747-9792

## Contact information

- **Practice address:** 530 E 31ST ST, STD 31ST STREET CLINIC, CHICAGO, IL 60616-4008
- **Practice address phone:** (312) 747-9792
- **Practice address fax:** (312) 747-9447
- **Mailing address:** 333 S STATE STREET, REVENUE \#200 CHICAGO DEPARTMENT OF PUBLIC HEALTH, CHICAGO, IL 60604
- **Mailing address phone:** (312) 747-9792
- **Mailing address fax:** (312) 747-9447

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | NULL | Yes |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/13/2006
- **Last updated:** 05/27/2008