Organization
CITY OF CHICAGO
Active
Organization
CITY OF CHICAGO
Active
Other names
Chicago Department of Public Health Revenue 3200
Organization subpart
No
Provider details
NPI number
Authorized official
TYANNA QUALLS (PROJECTS ADMINISTRATOR)
(312) 747-2203
Entity
Organization
Contact information
Practice address
111 W WASHINGTON ST FL 4, CHICAGO, IL 60602-2703
(312) 747-9884
(312) 747-9447
Mailing address
111 W WASHINGTON ST FL 4, CHICAGO, IL 60602-2703
(312) 747-9443
(312) 747-9447
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
IL
Other
Enumeration date
08/01/2005
Last updated
11/14/2024
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