Organization
IGIA FIRST INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA BLANCO (ADMINISTRATOR)
(773) 942-7428
Entity
Organization
Contact information
Practice address
5781 N LINCOLN AVE, CHICAGO, IL 60659-4722
(773) 942-7428
Mailing address
5781 N LINCOLN AVE, CHICAGO, IL 60659-4722
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036123281
IL
Other
Enumeration date
04/08/2013
Last updated
07/08/2013
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