Organization
JAVETTE C ORGAIN MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAVETTE C ORGAIN MD (PRESIDENT/CEO)
(312) 833-1077
Entity
Organization
Contact information
Practice address
9933 S WESTERN AVE, EMB - SUITE 103, CHICAGO, IL 60643-1810
(312) 833-1077
(877) 825-1491
Mailing address
PO BOX 806527, CHICAGO, IL 60680-4126
(312) 833-1077
(877) 825-1491
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/17/2009
Last updated
10/25/2013
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