Healthcare Provider Details

I. General information

NPI: 1639397516
Provider Name (Legal Business Name): URGENT CARE CENTER LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 11/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 N CENTRAL AVE
CHICAGO IL
60634-4426
US

IV. Provider business mailing address

1785 RIZZI LN
BARTLETT IL
60103-2903
US

V. Phone/Fax

Practice location:
  • Phone: 773-282-6230
  • Fax: 773-282-6241
Mailing address:
  • Phone: 630-289-6300
  • Fax: 630-289-6300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateIL

VIII. Authorized Official

Name: WESLY SPIRALA
Title or Position: PRESIDENT
Credential: PT
Phone: 773-282-6230