Organization
GRAND MEDICAL CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR GARCIA MD (OWNER)
(312) 733-9858
Entity
Organization
Contact information
Practice address
2158 W GRAND AVE, SUITE 101, CHICAGO, IL 60612-1571
(312) 733-9858
(312) 799-8661
Mailing address
2158 W GRAND AVE, SUITE 101, CHICAGO, IL 60612-1571
(312) 733-9858
(312) 799-8661
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036124389
IL
Other
Enumeration date
02/21/2011
Last updated
02/21/2011
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