Healthcare Provider Details

I. General information

NPI: 1467682872
Provider Name (Legal Business Name): UNIVERSAL MEDICAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 07/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1859 S BLUE ISLAND AVE
CHICAGO IL
60608-3012
US

IV. Provider business mailing address

1859 S BLUE ISLAND AVE
CHICAGO IL
60608-3012
US

V. Phone/Fax

Practice location:
  • Phone: 773-370-0324
  • Fax: 312-733-5327
Mailing address:
  • Phone: 773-370-0324
  • Fax: 312-733-5327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: PEKKA SOINI
Title or Position: CHAIRMAN
Credential: MD
Phone: 773-370-0324