Abraham'S Mark Comprehensive Wellness Center, Sc

LBN: Abraham'S Mark Comprehensive Wellness Center, Sc
Abraham'S Mark Comprehensive Wellness Center, Sc is an health care organization with primary practice located at 9500 S Dorchester Ave Ste 100, Chicago IL 60628-1700. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Primary Care. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty. Abraham'S Mark Comprehensive Wellness Center, Sc can be contacted via phone (773) 667-0768, or through King, Nicole D. via phone (773) 667-0768.

Contact Information

Primary practice address
9500 S Dorchester Ave Ste 100 Chicago IL 60628-1700
Phone: (773) 667-0768
Fax: (773) 667-5529
Website:
Map and Directions
Authorized official contact:
Name: King, Nicole D. Doctor of Medicine (MD)
Phone: (773) 667-0768

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Ambulatory Health Care Facilities / Primary Care 261QP2300X 036096686 Illinois

Profile Details

NPI number 1104857341
LBN Legal business name Abraham'S Mark Comprehensive Wellness Center, Sc
DBA Doing business as
Authorized official King, Nicole D. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 5th, 2006
Last updated Dec 3rd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104857341 NPPES
Illinois Other 1634166 BC/BS
Illinois Other 7455146 BC/BS
Illinois Other 7779286 BC/BS
Illinois Other 0061621 BC/BS
Illinois Other 3474878 BC/BS
Illinois Other DD6694 BC/BS

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