Organization
BELOVED COMMUNITY FAMILY WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARGIE JOHNSON (EXECUTIVE DIRECTOR)
(773) 651-3828
Entity
Organization
Contact information
Practice address
6821 S HALSTED ST, CHICAGO, IL 60621-1833
(773) 765-1382
(773) 651-3648
Mailing address
326 W 64TH ST, CHICAGO, IL 60621-3114
(773) 651-3828
(773) 651-3648
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
261QP2300X
IL
Other
Enumeration date
07/14/2006
Last updated
10/20/2011
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