# GABISA MEDICAL CHICAGO PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821765140
- **Authorized official:** MARCELO VENEGAS-PIZARRO MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (347) 524-1914

## Contact information

- **Practice address:** 4121 W NORTH AVE, CHICAGO, IL 60639-5205
- **Practice address phone:** (773) 697-8623
- **Practice address fax:** (888) 929-2371
- **Mailing address:** 3436 CLINTON AVE, BERWYN, IL 60402-3322
- **Mailing address phone:** (347) 524-1914
- **Mailing address fax:** (888) 929-2371

## Taxonomy

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

## Other

- **Enumeration date:** 08/25/2021
- **Last updated:** 08/25/2021