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Organization

COOK COUNTY

Active
Other names
DUSABLE ADOLESCENT HEALTH CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
SANDRA ANKEBRANT (COO)
(312) 864-0719
Entity
Organization

Contact information

Practice address
4934 S WABASH AVE RM 165, CHICAGO, IL 60615-2136
(773) 548-3651
Mailing address
1110 S OAKLEY BLVD, ROOM 200, CHICAGO, IL 60612-4218
(312) 864-4665

Taxonomy

Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
0004549
IL

Other

Enumeration date
03/29/2007
Last updated
08/22/2020
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