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NPI Code Detail

MEDICARE: CHICAGO DEPARTMENT OF PUBLIC HEALTH

MEDICARE: CHICAGO DEPARTMENT OF PUBLIC HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251K00000XPublic Health or Welfare AgencyIL

General Provider Information

NPI Number : 1497830376
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHICAGO DEPARTMENT OF PUBLIC HEALTH
Provider Business Mailing Address
First Line : 3519 W WRIGHTWOOD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-1248
Country : US
Telephone Number : 773-395-9314
Fax Number :
Provider Business Practice Location Address
First Line : 2418 W DIVISION ST
Second Line :
City : CHICAGO
State : IL
Zip : 60622-2940
Country : US
Telephone Number : 312-744-7448
Fax Number : 312-744-5516
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. DANIEL VITTUM
Credential :
Telephone Number : 312-744-7448
Provider Enumeration Date : 10/26/2006
Last Update Date : 08/22/2020

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Directions to “CHICAGO DEPARTMENT OF PUBLIC HEALTH ” Practice Location

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