Organization
CENTURY PHO, INC.
Active
Other names
Humboldt Park Health Partners
Organization subpart
No
Provider details
NPI number
Authorized official
KITA JOHNSON (EXECUTIVE DIRECTOR)
(773) 278-8685
Entity
Organization
Contact information
Practice address
1029 N SACRAMENTO AVE, CHICAGO, IL 60622-2746
(773) 278-8555
(773) 278-7515
Mailing address
1029 N. SACRAMENTO AVE., CHICAGO, IL 60622
(773) 278-8555
(773) 278-7515
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
02/28/2007
Last updated
03/03/2021
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