Organization
JEFFERSON PARK MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PIERRE CHATELAIN (OPERATIONS MANAGER)
(630) 209-8405
Entity
Organization
Contact information
Practice address
4955 N MILWAUKEE AVE, CHICAGO, IL 60630-2286
(630) 209-8405
(773) 736-1403
Mailing address
4955 N MILWAUKEE AVE, CHICAGO, IL 60630-2286
(630) 209-8405
(773) 736-1403
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036046595
—
IL
Enumeration date
05/22/2007
Last updated
07/10/2008
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