OrganizationActive
Cook County
NPI 1124148366 · Primary Care Clinic/Center · Chicago, IL
Provider details
- NPI number
- 1124148366
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Sandra Ankebrant, Coo
- License
- 0005272 (IL)
Mailing address
1110 S Oakley Blvd
Chicago, IL 60612-4218
Registry dates
- Enumerated
- 2007-03-30
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.