Whalio Doctors

NPI 1306952858

Broadway Medical Group

Organisation Legal Medicine Chicago, IL

Practice location

Address
4826 N. Broadway, Chicago, IL 60640
Phone
(773) 275-8333
Fax
(773) 275-9297
Mailing address
4826 N Broadway St, Chicago, IL 60640-3604

Authorised official

Name
K.J. J Philip
Title
Owner
Phone
(847) 475-6063

Registered specialties

Legal Medicine Primary
Other Service Providers Taxonomy 173000000X Licence 036110420 (IL)

Registry record

NPI
1306952858
Entity type
Organization
NPI issued
21 Aug 2006
Record last updated
13 Apr 2010

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.