NPI 1124579073

Uptown Dui Services

Organisation Exclusive Provider Organization Chicago, IL

Practice location

Address: 1525 E 53rd St STE 411, Chicago, IL 60615-4530
Phone: (312) 451-5184
Fax: (708) 896-6580

Authorised official

Name: Paul Fitzgerald Jordan
Title: Dui / Treatment Provider
Phone: (312) 451-5184

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 302F00000X (IL)

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Registry record

NPI: 1124579073
Entity type: Organization
NPI issued: 16 Oct 2016
Record last updated: 16 Oct 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.