22nd Century Healthcare, P.C.
General Practice in Chicago, IL. Organization (NPI-2).
NPI number1558595272
StatusActive
Last updated in NPPESMay 9, 2009
Details
- NPI
- 1558595272
- Entity type
- Organization (NPI-2)
- Legal business name
- 22nd Century Healthcare, P.C.
- Organization subpart
- No
- Enumeration date
- May 9, 2009
- Last updated
- May 9, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
| 208100000X | Physical Medicine & Rehabilitation | – | – | |
| 2081P2900X | Physical Medicine & Rehabilitation, Pain Medicine | – | – |
Practice location
875 N Michigan AveSuite 3100
Chicago, IL 60611-1803
Phone 773-362-5461
Mailing address
3712 N Broadway StSuite 629
Chicago, IL 60613-4235
Authorized official
Bo Headlam
Ceo
7733625461
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