Organization
COVID TESTING CENTERS AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WSAM TAIYM (OWNER)
(708) 997-4546
Entity
Organization
Contact information
Practice address
10158 S WESTERN AVE, CHICAGO, IL 60643-1928
(708) 465-2837
Mailing address
10158 S WESTERN AVE, CHICAGO, IL 60643-1928
(708) 465-2837
(773) 238-5903
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/03/2022
Last updated
02/03/2022
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