Grand Medical Clinic, INC

NPI #1457658841 in Chicago, Illinois

Provider Information

NPI Number: 1457658841
Entity Type: Organization
Organization Name: Grand Medical Clinic, INC
Primary Specialty: Surgery
Enumeration Date: Feb 21, 2011
Last Updated: Feb 21, 2011

Practice Location

Address: 2158 W GRAND AVE
Address 2: SUITE 101
City: Chicago
State: Illinois
ZIP Code: 60612-1571
Phone: (312) 733-9858

Authorized Official

Name: OMAR GARCIA, MD
Title: OWNER
Phone: (312) 733-9858

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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