Organization
CHICAGOLAND FAMILY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLA AZAR MD (OWNER)
(773) 334-6370
Entity
Organization
Contact information
Practice address
5151 N LINCOLN AVE, CHICAGO, IL 60625-2520
(773) 334-6370
Mailing address
5151 N LINCOLN AVE, CHICAGO, IL 60625-2520
(773) 334-6370
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036121756
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212506
MEDICARE
IL
Enumeration date
08/03/2010
Last updated
09/06/2010
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