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General NPI Number Information
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NPI Number | 1275195059
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Entity Type | Organization
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Legal Business Name | SURE WORK HEALTH CLINIC LTD
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Dates
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Enumeration Date | 07/02/2019
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Last Update Date | 07/02/2019
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Provider Practice Location Address
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Address Line | 830 N ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60622-5684
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Country | US
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Telephone | 312-624-8364
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Fax |
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Provider Business Mailing Address
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Address Line | 830 N ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60622-5684
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Country | US
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Telephone | 312-624-8364
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. NEEMA BAYRAN
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Credential | MD
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Telephone | 312-624-8364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0010X
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Taxonomy Name | Sports Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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