Organization
NORTHWEST MEDICAL AND URGENT CARE CENTER AT SOUTH SHORE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMARA PETROV (OFFICE MANAGER)
(773) 353-5047
Entity
Organization
Contact information
Practice address
1952 E 73RD ST, CHICAGO, IL 60649-2902
(773) 493-5600
Mailing address
5352 N LINCOLN AVE, CHICAGO, IL 60625-2316
(773) 353-5047
(773) 353-2406
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/03/2018
Last updated
07/03/2018
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