Healthcare Provider Details

I. General information

NPI: 1073057873
Provider Name (Legal Business Name): FAMILY URGENT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2016
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 FAIRWAY DR SUITE 107
NAPERVILLE IL
60563-3938
US

IV. Provider business mailing address

535 FAIRWAY DR SUITE 107
NAPERVILLE IL
60563-3938
US

V. Phone/Fax

Practice location:
  • Phone: 773-852-5345
  • Fax: 630-397-4204
Mailing address:
  • Phone: 773-852-5345
  • Fax: 630-397-4204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number036126023
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number036126023
License Number StateIL

VIII. Authorized Official

Name: DR. FOUZIA MUHAMMEDKARIM
Title or Position: PRESIDENT
Credential: M.D
Phone: 773-852-5345