Unknown Individual – Primary Care Clinic/Center, NPI 1306863279
Primary Care Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
4177-4197, South Archer Avenue, Brighton Park, Chicago, Lake Township, Cook County, Illinois, 60632, United States
CHICAGO, IL 606321849
Phone: (773) 254-2222
Fax: (773) 254-8444
Type: Mailing
3124, West 59th Street, Chicago Lawn, Chicago, Lake Township, Cook County, Illinois, 60629, United States
CHICAGO, IL 606292504
Phone: (773) 776-3422
Fax: (773) 776-3457
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60632)
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