Family Doctor Medical Center

LBN: Family Doctor Medical Center
Family Doctor Medical Center is an health care organization with primary practice located at 1918 W Irving Park Rd , Chicago IL 60613-2408. The organization recently has only one registered license in Ambulatory Health Care Facilities / Medical Specialty, which is considered as the primary health care specialty. Family Doctor Medical Center can be contacted via phone (773) 940-1612, or through Jackson, Julia via phone (773) 940-1612.

Contact Information

Primary practice address
1918 W Irving Park Rd Chicago IL 60613-2408
Phone: (773) 940-1612
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jackson, Julia Master of Arts (MA)
Phone: (773) 940-1612

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X 036101658 Illinois

Profile Details

NPI number 1336516780
LBN Legal business name Family Doctor Medical Center
DBA Doing business as
Authorized official Jackson, Julia Master of Arts (MA)
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 1st, 2015
Last updated Sep 1st, 2015 - about 9 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 1336516780 NPPES
Illinois MEDICAID 20000890

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