Fullerton Occupational Medicine & Immediate Care Sc

LBN: Fullerton Occupational Medicine & Immediate Care Sc
Fullerton Occupational Medicine & Immediate Care Sc is an health care organization with primary practice located at 3409 W Fullerton Ave , Chicago IL 60647-2415. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Physical Therapy, Ambulatory Health Care Facilities / Urgent Care, Ambulatory Health Care Facilities / Occupational Medicine. Ambulatory Health Care Facilities / Occupational Medicine is the primary health care specialty. Fullerton Occupational Medicine & Immediate Care Sc can be contacted via phone (773) 486-5001, or through Xia, Renlin via phone (773) 486-5001.

Contact Information

Primary practice address
3409 W Fullerton Ave Chicago IL 60647-2415
Phone: (773) 486-5001
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Xia, Renlin Doctor of Medicine (MD)
Phone: (773) 486-5001

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Physical Therapy 261QP2000X 364061160 Illinois
Ambulatory Health Care Facilities / Urgent Care 261QU0200X 364061160 Illinois
Ambulatory Health Care Facilities / Occupational Medicine 261QX0100X 364061160 Illinois

Profile Details

NPI number 1740304757
LBN Legal business name Fullerton Occupational Medicine & Immediate Care Sc
DBA Doing business as
Authorized official Xia, Renlin Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 16th, 2007
Last updated Apr 13th, 2010 - about 14 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 1740304757 NPPES
Illinois MEDICAID 036088691 4
Illinois Other 01635426

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