Organization
NORTH CHICAGO LICE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMI IMSAIH (OWNER)
(773) 620-7961
Entity
Organization
Contact information
Practice address
6308 N MILWAUKEE AVE, CHICAGO, IL 60646-3711
(773) 430-5679
Mailing address
6308 N MILWAUKEE AVE, CHICAGO, IL 60646-3711
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
10/22/2018
Last updated
10/22/2018
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