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Organization

FAMILY DOC, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ADEBAYO ADEL BADEMOSI M.D (PRESIDENT)
(773) 940-1612
Entity
Organization

Contact information

Practice address
7207 S STONY ISLAND AVE, CHICAGO, IL 60649-2806
(773) 940-1612
(773) 940-1567
Mailing address
7207 S STONY ISLAND AVE, CHICAGO, IL 60649-2806
(773) 940-1612
(773) 940-1567

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036101658
IL
Enumeration date
01/28/2010
Last updated
04/29/2013
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