NPI 1376700732

Advocate Illinois Masonic

Organisation Student in an Organized Health Care Education/Training Program Chicago, IL

Practice location

Address: 836 W Wellington Ave Family Practice, Chicago, IL 60657-5147
Phone: (773) 296-8250
Mailing address: 3430 N Elaine Pl APT 4, Chicago, IL 60657-2483

Authorised official

Name: Evelyn Cotto
Title: Residency Coordinator
Phone: (773) 296-8250

Registered specialties

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1376700732
Entity type: Organization
NPI issued: 21 May 2008
Record last updated: 21 May 2008

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.