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General NPI Number Information
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NPI Number | 1518021153
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Entity Type | Organization
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Legal Business Name | CITY OF CHICAGO
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 2160 W. OGDEN WESTSIDE C.D.C
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City | CHICAGO
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State | IL
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Zip | 60604
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Country | US
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Telephone | 312-747-9792
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Fax | 312-747-9447
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Provider Business Mailing Address
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Address Line | 111 W WASHINGTON ST FL 4
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City | CHICAGO
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State | IL
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Zip | 60602-2703
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Country | US
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Telephone | 312-747-9792
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Fax | 312-767-9447
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Authorized Official
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Title or Position | DIRECTOR OF REVENUE
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Name | SARAI M. JACKSON
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Credential | DIRECTOR
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Telephone | 312-747-9792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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