Altagracia Medical Center

LBN: Altagracia Clinic Sc
Altagracia Medical Center is an health care organization with primary practice located at 3754 W Irving Park Rd , Chicago IL 60618. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Altagracia Clinic Sc can be contacted via phone (773) 509-1467, or through Aswad, Ghassan D via phone (773) 509-1467.

Contact Information

Primary practice address
3754 W Irving Park Rd Chicago IL 60618
Phone: (773) 509-1467
Fax: (773) 509-1695
Website:
Map and Directions
Authorized official contact:
Name: Aswad, Ghassan D Doctor of Medicine (MD)
Phone: (773) 509-1467

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X Illinois

Profile Details

NPI number 1578643755
LBN Legal business name Altagracia Clinic Sc
DBA Doing business as Altagracia Medical Center
Authorized official Aswad, Ghassan D Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 16th, 2006
Last updated Aug 22nd, 2020 - about 6 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 1578643755 NPPES
Illinois Other 1629946 B/C B/S

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