Organization
CHICAGO MEDICAL CENTER,SC
Active
Organization
CHICAGO MEDICAL CENTER,SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRA MUNTEANU MD (PRACTICE OWNER)
(773) 248-0300
Entity
Organization
Contact information
Practice address
4112 N LINCOLN AVE, CHICAGO, IL 60618-3028
(773) 248-0300
(773) 248-0303
Mailing address
PO BOX 597781, CHICAGO, IL 60659-7781
(773) 248-0300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03609939
—
IL
Enumeration date
10/02/2007
Last updated
10/12/2007
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