Organization
TCA HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARQUETTA D HALL MD (BILLING SPECIALIST)
(708) 856-7556
Entity
Organization
Contact information
Practice address
1030 E. 130TH ST, CHICAGO, IL 60628
(773) 995-1462
(773) 995-7985
Mailing address
1029 E 130TH ST, CHICAGO, IL 60628-6908
(773) 995-1462
(773) 995-7985
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
1588701452
IL
261Q00000X
Clinic/Center
Primary
1578936696
IL
Other
Enumeration date
10/07/2016
Last updated
10/07/2016
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