Organization
MICHIGAN AVENUE CENTER FOR HEALTH, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY STERN (ASSISTANT ADMINISTRATOR)
(847) 255-7400
Entity
Organization
Contact information
Practice address
2415 S MICHIGAN AVE, CHICAGO, IL 60616-2301
(312) 328-1200
Mailing address
PO BOX 661066, CHICAGO, IL 60666-1066
(847) 255-7400
(847) 398-4585
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7002777
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50422
BC BS NUMBER
IL
Enumeration date
02/20/2007
Last updated
08/22/2020
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