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General NPI Number Information
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NPI Number | 1396595518
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Entity Type | Organization
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Legal Business Name | FAMILYDOK URGENT CARE, LLC
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Dates
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Enumeration Date | 03/22/2024
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Last Update Date | 03/22/2024
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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 | 60649-2806
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Country | US
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Telephone | 773-639-1335
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Fax | 773-940-1567
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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 | 60649-2806
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Country | US
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Telephone | 773-639-1335
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Fax | 773-940-1567
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | ADEBAYO BADEMOSI
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Credential | MD
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Telephone | 773-639-1335
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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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