Organization · NPI-2

31st Std Clinic

Preventive Medicine, Public Health & General Preventive Medicine · Chicago, IL

NPI number1821159625
StatusActive
Last updated in NPPESMay 27, 2008

Details

NPI
1821159625
Entity type
Organization (NPI-2)
Legal business name
31st Std Clinic
Organization subpart
No
Enumeration date
Dec 13, 2006
Last updated
May 27, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2083P0901X Preventive Medicine, Public Health & General Preventive Medicine––Yes

Other names

  • 31st Street Sexually Transmitted Diseases (Other Name)

Practice location

530 E 31st St
Std 31st Street Clinic
Chicago, IL 60616-4008

Phone 312-747-9792 · Fax 312-747-9447

Mailing address

333 S State Street
Revenue #200 Chicago Department Of Public Health
Chicago, IL 60604

Phone 312-747-9792 · Fax 312-747-9447

Authorized official

Sarai M Jackson
Director Of Revenue
3127479792

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