Chicago Monticello Medical Ctr

NPI #1447265053 in Chicago, Illinois

Provider Information

NPI Number
1447265053
Entity Type
Organization
Organization Name
Chicago Monticello Medical Ctr
Primary Specialty
Non-Pharmacy Dispensing Site
Enumeration Date
Jul 30, 2006
Last Updated
Nov 19, 2007

Practice Location

Address
3623 W CHICAGO AVE
ZIP Code
60651-3934
Phone
(773) 722-6171

Authorized Official

Name
MICHAEL EARLEY
Title
MD
Phone
(773) 722-6171

Specialties & Taxonomy Codes

Specialty
Non-Pharmacy Dispensing Site

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