Organization
BRIDGEPORT FAMILY MEDICAL CENTER S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERROLD SCHWARTZ D.O. (PRESIDENT)
(312) 203-2714
Entity
Organization
Contact information
Practice address
3201 S WALLACE ST, CHICAGO, IL 60616-3501
(312) 326-3200
Mailing address
3201 S WALLACE, CHICAGO, IL 60611-6061
(312) 326-3200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/19/2010
Last updated
05/19/2010
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