Organization
MICHIGAN AVE MEDICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTO DIAZ (SOLE MEMBER)
(312) 521-5510
Entity
Organization
Contact information
Practice address
845 N MICHIGAN AVE STE 930E, CHICAGO, IL 60611-2213
(312) 202-0700
Mailing address
845 N MICHIGAN AVE STE 910W, CHICAGO, IL 60611-2252
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/15/2011
Last updated
03/15/2011
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