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NPI Code Detail

MEDICARE: BELLE CENTER OF CHICAGO INC

MEDICARE: BELLE CENTER OF CHICAGO INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QC1500XCommunity Health Clinic/Center

General Provider Information

NPI Number : 1306861034
Entity Type Code : Organization
Provider Name (Legal Business Name) : BELLE CENTER OF CHICAGO INC
Provider Business Mailing Address
First Line : 1754 W WILSON AVE
Second Line : BELLE CENTER OF CHICAGO INC
City : CHICAGO
State : IL
Zip : 60640
Country : US
Telephone Number : 773-878-7868
Fax Number : 773-878-7869
Provider Business Practice Location Address
First Line : 1754 W WILSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60640
Country : US
Telephone Number : 773-878-7868
Fax Number : 773-878-7869
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. BETH CATHERINE VALUKAS
Credential :
Telephone Number : 773-878-7868
Provider Enumeration Date : 07/13/2006
Last Update Date : 08/22/2020

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Directions to “BELLE CENTER OF CHICAGO INC ” Practice Location

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