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General NPI Number Information
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NPI Number | 1811028699
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Entity Type | Organization
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Legal Business Name | HPW CENTER FOR DIABETES INC
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 515 EAST 50TH STREET 2ND FLOOR
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City | CHICAGO
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State | IL
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Zip | 60615
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Country | US
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Telephone | 773-624-8000
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Fax | 773-624-8021
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Provider Business Mailing Address
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Address Line | 515 EAST 50TH STREET 2ND FLOOR
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City | CHICAGO
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State | IL
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Zip | 60615
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Country | US
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Telephone | 773-624-8000
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Fax | 773-624-8021
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Authorized Official
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Title or Position | OWNER-DIRECTOR
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Name | DR. ISAIAH PITTMAN IV
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Credential | M.D. PHD
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Telephone | 773-624-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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