Organization
NORTHWEST MEDICAL AND URGENT CARE CENTER AT YALE AND 95TH LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD KHAMIS MD (PRESIDENT)
(773) 468-2110
Entity
Organization
Contact information
Practice address
237 W 95TH ST, CHICAGO, IL 60628-1321
(773) 468-2110
(773) 468-2109
Mailing address
5352 N LINCOLN AVE, CHICAGO, IL 60625-2316
(773) 353-5047
(773) 353-2406
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036112029
—
IL
Enumeration date
11/13/2017
Last updated
10/24/2018
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