Provider Demographics
NPI:1639397516
Name:URGENT CARE CENTER LTD
Entity Type:Organization
Organization Name:URGENT CARE CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WESLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIRALA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:773-282-6230
Mailing Address - Street 1:1785 RIZZI LN
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-2903
Mailing Address - Country:US
Mailing Address - Phone:630-289-6300
Mailing Address - Fax:630-289-6300
Practice Address - Street 1:3401 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4426
Practice Address - Country:US
Practice Address - Phone:773-282-6230
Practice Address - Fax:773-282-6241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1627199OtherBCBS