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General NPI Number Information
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NPI Number | 1902647894
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Entity Type | Organization
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Legal Business Name | MIDWEST EXPRESS CARE 2, INC
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 3333 W FULLERTON AVE
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City | CHICAGO
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State | IL
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Zip | 60647-2513
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Country | US
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Telephone | 773-257-0610
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Fax | 312-500-5037
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Provider Business Mailing Address
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Address Line | 3333 W FULLERTON AVE
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City | CHICAGO
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State | IL
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Zip | 60647-2513
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Country | US
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Telephone | 773-257-0610
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Fax | 312-500-5037
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Authorized Official
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Title or Position | OWNER
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Name | MILAP SHAH
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Credential |
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Telephone | 219-802-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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