| Uic-mshc James Jordan Family Life Center | |
|
2102 W Monroe St Chicago IL 60612-3015 | |
| (312) 996-2000 | |
| (312) 413-1782 |
| Full Name | Uic-mshc James Jordan Family Life Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2102 W Monroe St, Chicago, Illinois |
| Authorized Official Name and Position | Inn Lee (ASSOCIATE DIRECTOR) |
| Authorized Official Contact | 3124139854 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Uic-mshc James Jordan Family Life Center 2045 W Washington Blvd M/c 698 Chicago IL 60612-2428 Ph: (312) 996-2000 | Uic-mshc James Jordan Family Life Center 2102 W Monroe St Chicago IL 60612-3015 Ph: (312) 996-2000 |
| NPI Number | 1033135041 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 08/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033135041 | NPI | - | NPPES |
| 1622185 | Other | BCBS PROVIDER ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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