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General NPI Number Information
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NPI Number | 1245880715
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Entity Type | Organization
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Legal Business Name | FAMILYDOC URGENT CARE LLC
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Dates
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Enumeration Date | 09/17/2019
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Last Update Date | 06/01/2022
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Provider Practice Location Address
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Address Line | 7201 S STONY ISLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60649
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Country | US
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Telephone | 773-940-1612
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Fax | 630-559-7349
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Provider Business Mailing Address
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Address Line | 7201 S STONY ISLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60649
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Country | US
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Telephone | 773-940-1612
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Fax | 630-559-7349
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Authorized Official
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Title or Position | OWNER
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Name | DR. ADEBAYO BADEMOSI
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Credential | MD
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Telephone | 773-940-1612
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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