Organization
HOLY FAMILY MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN PASCUAL (M.D)
(708) 780-7400
Entity
Organization
Contact information
Practice address
4941 W 14TH ST, CICERO, IL 60804-1419
(708) 780-7400
Mailing address
4941 W 14TH ST, CICERO, IL 60804-1419
(708) 780-7400
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036067770
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031601680
BCBS
IL
05
—
036067770
—
IL
Enumeration date
04/16/2007
Last updated
07/01/2008
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