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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