Organization · NPI-2
Absolutecare Of Illinois, PLLC
Clinic/Center, Multi-Specialty · Chicago, IL
NPI number1407674104
StatusActive
Last updated in NPPESNov 5, 2024
Details
- NPI
- 1407674104
- Entity type
- Organization (NPI-2)
- Legal business name
- Absolutecare Of Illinois, PLLC
- Organization subpart
- No
- Enumeration date
- Oct 1, 2024
- Certification date
- Nov 5, 2024
- Last updated
- Nov 5, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | Yes |
| 251S00000X | Community/Behavioral Health | – | – |
Practice location
2627 W Cermak RdChicago, IL 60608-3514
Phone 667-400-0048
Mailing address
10175 Little Patuxent Pkwy Ste 800Columbia, MD 21044-3401
Authorized official
Gregory P. Foti
President
4437380225
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