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General NPI Number Information
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NPI Number | 1841853116
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Entity Type | Organization
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Legal Business Name | APEX INTEGRATED MEDICAL CENTER LTD
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Dates
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Enumeration Date | 04/22/2019
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 118 N CLINTON ST STE 103
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City | CHICAGO
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State | IL
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Zip | 60661-2388
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Country | US
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Telephone | 312-208-9990
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Fax | 866-610-9462
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Provider Business Mailing Address
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Address Line | 118 N CLINTON ST STE 103
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City | CHICAGO
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State | IL
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Zip | 60661-2388
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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 | ADMINISTRATOR
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Name | CLARENCE W BROWN III
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Credential |
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Telephone | 312-208-9990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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