| Antillas South Medical Center, Inc | |
|
5159 S Damen Ave Chicago IL 60609-5631 | |
| (773) 776-7800 | |
| (773) 776-1119 |
| Full Name | Antillas South Medical Center, Inc |
|---|---|
| Speciality | Pediatrics |
| Location | 5159 S Damen Ave, Chicago, Illinois |
| Authorized Official Name and Position | Lee Burstein (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Contact | 7733945260 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Antillas South Medical Center, Inc 3111 W Armitage Ave Chicago IL 60647-3818 Ph: (773) 394-5260 | Antillas South Medical Center, Inc 5159 S Damen Ave Chicago IL 60609-5631 Ph: (773) 776-7800 |
| NPI Number | 1346304003 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346304003 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
| 207R00000X | Internal Medicine | (Illinois) | Primary |
| 208000000X | Pediatrics | (Illinois) | Primary |
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