Jefferson Park Medical Center

LBN: Jefferson Park Medical Center
Jefferson Park Medical Center is an health care organization with primary practice located at 4955 N Milwaukee Ave , Chicago IL 60630-2286. The organization recently has only one registered license in Ambulatory Health Care Facilities / Medical Specialty, which is considered as the primary health care specialty. Jefferson Park Medical Center can be contacted via phone (630) 209-8405, or through Chatelain, Pierre via phone (630) 209-8405.

Contact Information

Primary practice address
4955 N Milwaukee Ave Chicago IL 60630-2286
Phone: (630) 209-8405
Fax: (773) 736-1403
Website:
Map and Directions
Authorized official contact:
Name: Chatelain, Pierre
Phone: (630) 209-8405

Health care specialties

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

Profile Details

NPI number 1194934208
LBN Legal business name Jefferson Park Medical Center
DBA Doing business as
Authorized official Chatelain, Pierre
Entity Organization
Organization subpart 1 No
Enumeration date May 22nd, 2007
Last updated Jul 10th, 2008 - about 17 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 1194934208 NPPES
Illinois MEDICAID 036046595

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