Organization
ALTAGRACIA CLINIC SC
Active
Other names
Altagracia Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
GHASSAN D ASWAD MD (CEO)
(773) 509-1467
Entity
Organization
Contact information
Practice address
3754 W IRVING PARK RD, CHICAGO, IL 60618
(773) 509-1467
(773) 509-1695
Mailing address
3754 W IRVING PARK RD, CHICAGO, IL 60618
(773) 509-1467
(773) 509-1695
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629946
B/C B/S
IL
Enumeration date
10/16/2006
Last updated
09/11/2025
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