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General NPI Number Information
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NPI Number | 1841945706
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Entity Type | Organization
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Legal Business Name | WEST CHICAGO IMMEDIATE CARE AND MEDICAL CENTER
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Dates
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Enumeration Date | 02/18/2022
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Last Update Date | 02/18/2022
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Provider Practice Location Address
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Address Line | 206 S NELTNOR BLVD
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City | WEST CHICAGO
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State | IL
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Zip | 60185-2847
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Country | US
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Telephone | 773-658-0311
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 578220
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City | CHICAGO
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State | IL
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Zip | 60657-7303
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Country | US
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Telephone | 773-935-4700
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KALID ADAB
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Credential | MD
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Telephone | 773-658-0311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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