Provider Demographics
NPI:1629248182
Name:FAMILY HEALTHCARE CENTER, LTD
Entity Type:Organization
Organization Name:FAMILY HEALTHCARE CENTER, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:WALDO
Authorized Official - Middle Name:J
Authorized Official - Last Name:ARTEAGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-927-5564
Mailing Address - Street 1:100 E 14TH ST APT 904
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3666
Mailing Address - Country:US
Mailing Address - Phone:773-927-5524
Mailing Address - Fax:773-804-8450
Practice Address - Street 1:1845 W 47TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60609
Practice Address - Country:US
Practice Address - Phone:773-927-5524
Practice Address - Fax:773-804-8450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036066474207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty