# JEFFERSON PARK MEDICAL CENTER, LTD.

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

## Provider details

- **NPI number:** 1952577926
- **Authorized official:** MILROY EMMANUEL (INCORPORATOR)
- **Authorized official phone:** (773) 736-3770

## Contact information

- **Practice address:** 4955 N MILWAUKEE AVE STE 4, CHICAGO, IL 60630-2175
- **Practice address phone:** (773) 736-3770
- **Practice address fax:** (773) 736-1403
- **Mailing address:** 4955 N MILWAUKEE AVE STE 4, CHICAGO, IL 60630-2175
- **Mailing address phone:** (773) 736-3770
- **Mailing address fax:** (773) 736-1403

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 042.619228 | IL | Yes |

## Other

- **Enumeration date:** 04/30/2008
- **Last updated:** 04/30/2008