Organization
MILE SQUARE DRAKE HEALTH AND WELLNESS CENTER
Active
Organization
MILE SQUARE DRAKE HEALTH AND WELLNESS CENTER
Active
Parent organization
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Authorized official
MR. HENRY TAYLOR (EXECUTIVE DIRECTOR)
(312) 412-1261
Entity
Organization
Contact information
Practice address
2710 S DEARBORN ST, CHICAGO, IL 60616-2684
(312) 949-0379
(312) 949-1473
Mailing address
2710 S DEARBORN ST, CHICAGO, IL 60616-2684
(312) 949-0379
(312) 949-1473
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
02/10/2017
Last updated
02/10/2017
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