Provider Demographics
NPI:1396991972
Name:ALLERGY & ASTHMA FAMILY CLINIC, S.C.
Entity type:Organization
Organization Name:ALLERGY & ASTHMA FAMILY CLINIC, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-325-2037
Mailing Address - Street 1:454 S CLAY ST
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-4036
Mailing Address - Country:US
Mailing Address - Phone:630-325-2037
Mailing Address - Fax:
Practice Address - Street 1:5423 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-3789
Practice Address - Country:US
Practice Address - Phone:708-422-4848
Practice Address - Fax:708-422-7342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042618061207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty