Organization
CHICAGO CITY OF
Active
Organization
CHICAGO CITY OF
Active
Other names
South Austin Specialty Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE MORRIS (PROJECT ADMINISTRATOR)
(312) 747-9545
Entity
Organization
Contact information
Practice address
4909 W DIVISION ST, ROOM 41, CHICAGO, IL 60651-3161
(312) 746-4271
(312) 746-4637
Mailing address
4909 W DIVISION ST, ROOM 41, CHICAGO, IL 60651-3161
(312) 746-4271
(312) 746-4637
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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