| Clinic 1, LLC | |
|
4759 N Kedzie Ave Suite 100 Chicago IL 60625-4420 | |
| (773) 685-9900 | |
| (773) 685-9910 |
| Full Name | Clinic 1, LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 4759 N Kedzie Ave, Chicago, Illinois |
| Authorized Official Name and Position | Kashif M Riaz (CEO) |
| Authorized Official Contact | 7739960919 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinic 1, LLC 5901 N Cicero Ave Suite 400 Chicago IL 60646-5717 Ph: (773) 685-9900 | Clinic 1, LLC 4759 N Kedzie Ave Suite 100 Chicago IL 60625-4420 Ph: (773) 685-9900 |
| NPI Number | 1760858633 |
|---|---|
| Provider Enumeration Date | 08/14/2015 |
| Last Update Date | 08/14/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760858633 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 207R00000X | Internal Medicine | () | Secondary |
| 2085B0100X | Radiology - Body Imaging | () | Secondary |
| 363A00000X | Physician Assistant | () | Secondary |
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