Organization
FOUNDATION FOR OUTREACH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES HOLLAND (CEO)
(773) 962-4100
Entity
Organization
Contact information
Practice address
326 W 64TH ST, CHICAGO, IL 60621-3114
(773) 962-4100
Mailing address
326 W 64TH ST, CHICAGO, IL 60621-3114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/09/2014
Last updated
06/09/2014
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