Organization
INTERAMERICAN CLINICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANA E CASTELLANOS (PRESIDENT)
(773) 252-1147
Entity
Organization
Contact information
Practice address
2651 W DIVISION ST, 1ST FLOOR, CHICAGO, IL 60622
(773) 252-1147
(773) 252-5938
Mailing address
PO BOX 470717, INTERAMERICAN CLINICAL SERVICES, CHICAGO, IL 60647-0717
(773) 252-5938
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
55812
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21621949
—
IL
Enumeration date
01/08/2007
Last updated
08/22/2020
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