Organization
COMMUNITY FAMILY MEDICINE LTD
Active
Other names
EDITH CHAFFIN MD
Organization subpart
No
Provider details
NPI number
Authorized official
EDITH CHAFFIN MD (OWNER/PRESIDENT)
(773) 487-3017
Entity
Organization
Contact information
Practice address
6307 S STEWART AVE STE 310, CHICAGO, IL 60621-3116
(773) 487-3017
(773) 487-3028
Mailing address
6307 S STEWART AVE STE 310, CHICAGO, IL 60621-3116
(773) 487-3017
(773) 487-3028
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
036067419
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036067419
—
IL
01
—
1306899216
PROVIDER NPI
IL
Enumeration date
01/14/2008
Last updated
06/03/2020
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