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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