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General NPI Number Information
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NPI Number | 1710493572
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Entity Type | Organization
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Legal Business Name | PAK AMERICAN MEDICAL CENTER, NFP
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Dates
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Enumeration Date | 12/15/2017
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Last Update Date | 12/15/2017
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Provider Practice Location Address
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Address Line | 6201 N CALIFORNIA AVE STE 110
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City | CHICAGO
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State | IL
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Zip | 60659-2672
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Country | US
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Telephone | 773-381-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 6201 N CALIFORNIA AVE STE 110
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City | CHICAGO
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State | IL
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Zip | 60659-2672
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. MUBASHER FEROZE
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Credential |
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Telephone | 773-414-9438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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