| Target Clinic | |
|
1154 S Clark St Chicago IL 60605-2159 | |
| (312) 212-6300 | |
| Not Available |
| Full Name | Target Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 1154 S Clark St, Chicago, Illinois |
| Authorized Official Name and Position | Elizabeth Marie Jacobsma (NURSE PRACTITIONER) |
| Authorized Official Contact | 5635053837 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Target Clinic 4733 N Clark St Apt 2n Chicago IL 60640-7555 | Target Clinic 1154 S Clark St Chicago IL 60605-2159 Ph: (312) 212-6300 |
| NPI Number | 1023448644 |
|---|---|
| Provider Enumeration Date | 11/18/2013 |
| Last Update Date | 11/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023448644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 209010998 (Illinois) | Primary |
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