Organization
CHICAGO FAMILY MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMED RIAZUDDIN MD (PRESIDENT)
(630) 495-3333
Entity
Organization
Contact information
Practice address
1512 W CHICAGO AVE, SUITE 1, CHICAGO, IL 60642-5204
(630) 495-3333
Mailing address
1512 W CHICAGO AVE, SUITE 1, CHICAGO, IL 60642-5204
(630) 495-3333
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
036065312
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588755409
NPI
IL
Enumeration date
05/07/2014
Last updated
05/07/2014
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