Mamanatandathernizampc.

NPI #1104134915 in Chicago, Illinois

Provider Information

NPI Number
1104134915
Entity Type
Organization
Organization Name
Mamanatandathernizampc.
Primary Specialty
Clinic/Center - Community Health
Enumeration Date
Sep 15, 2010
Last Updated
Sep 15, 2010

Practice Location

Address
2001 W.69THST.
ZIP Code
60636
Phone
(773) 778-2355

Authorized Official

Name
DR. MAIMANAT NIZAM, MD.
Title
PHYSICIAN
Phone
(630) 654-1021

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Community HealthCommunity Health

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