Advocate Illinois Masonic

NPI #1376700732 in Chicago, Illinois

Provider Information

NPI Number
1376700732
Entity Type
Organization
Organization Name
Advocate Illinois Masonic
Primary Specialty
Student in an Organized Health Care Education/Training Program
Enumeration Date
May 21, 2008
Last Updated
May 21, 2008

Practice Location

Address
836 W WELLINGTON AVE
Address 2
FAMILY PRACTICE
ZIP Code
60657-5147
Phone
(773) 296-8250

Authorized Official

Name
EVELYN COTTO
Title
RESIDENCY COORDINATOR
Phone
(773) 296-8250

Specialties & Taxonomy Codes

Specialty
Student in an Organized Health Care Education/Training Program

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