Healthcare Provider Details

I. General information

NPI: 1760329098
Provider Name (Legal Business Name): FAMILY PRIMARY AND URGENT PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 W DEVON AVE STE 210 UNIT B
CHICAGO IL
60646-4537
US

IV. Provider business mailing address

4001 W DEVON AVE STE 210 UNIT B
CHICAGO IL
60646-4537
US

V. Phone/Fax

Practice location:
  • Phone: 773-887-6900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ABDUL MOGHNI
Title or Position: PRESIDENT
Credential:
Phone: 773-887-6900