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General NPI Number Information
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NPI Number | 1104940618
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Entity Type | Organization
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Legal Business Name | CAL DEVON URGENT CARE INC
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6415 N CALIFORNIA AVE
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City | CHICAGO
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State | IL
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Zip | 60645-5208
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Country | US
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Telephone | 773-262-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 6415 N CALIFORNIA AVE
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City | CHICAGO
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State | IL
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Zip | 60645-5208
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Country | US
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Telephone | 773-262-5400
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MIRZA BAIG
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Credential |
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Telephone | 773-262-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 001
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License Number State | IL
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