Abraham'S Mark Comprehensive Wellness Center, Sc
Clinic/Center, Primary Care in Chicago, IL. Organization (NPI-2).
NPI number1104857341
StatusActive
Last updated in NPPESMar 29, 2026
Details
- NPI
- 1104857341
- Entity type
- Organization (NPI-2)
- Legal business name
- Abraham'S Mark Comprehensive Wellness Center, Sc
- Organization subpart
- No
- Enumeration date
- Jul 5, 2006
- Certification date
- Mar 29, 2026
- Last updated
- Mar 29, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | 036096686 | IL | Yes |
| 207Q00000X | Family Medicine | – | – |
Practice location
9500 S Dorchester AveSte 100
Chicago, IL 60628-1700
Phone 773-667-0768 · Fax 773-667-5529
Mailing address
Po Box 13677Belfast, ME 04915-4027
Phone 773-667-0768 · Fax 773-667-5529
Authorized official
Nicole D. King
Owner
7736670768
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