Healthcare Provider Details

I. General information

NPI: 1699798058
Provider Name (Legal Business Name): URGENT CARE CENTER SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4250 N MARINE DR SUITE 236
CHICAGO IL
60613-1744
US

IV. Provider business mailing address

2300 W PETERSON AVE
CHICAGO IL
60659-5203
US

V. Phone/Fax

Practice location:
  • Phone: 773-404-0160
  • Fax:
Mailing address:
  • Phone: 773-508-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AREF SENNO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 773-508-9800