NPI 1619756889

Vaccine Clinics Sc

Organisation General Practice Physician Lincolnwood, IL

Practice location

Address: 7257 N Lincoln Ave, Lincolnwood, IL 60712-1810
Phone: (917) 275-5134

Authorised official

Name: Judah Kanowitz
Title: Authorized Official
Phone: (917) 275-5134

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

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Registry record

NPI: 1619756889
Entity type: Organization
NPI issued: 26 Sep 2023
Record last updated: 26 Sep 2023

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.