Provider Demographics
NPI:1881063949
Name:MAY MEDICAL CENTER
Entity type:Organization
Organization Name:MAY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PERCY
Authorized Official - Middle Name:CONRAD
Authorized Official - Last Name:MAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:773-533-1417
Mailing Address - Street 1:3857 W WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60624-2342
Mailing Address - Country:US
Mailing Address - Phone:773-533-1417
Mailing Address - Fax:773-533-7348
Practice Address - Street 1:3857 W WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-2342
Practice Address - Country:US
Practice Address - Phone:773-533-1417
Practice Address - Fax:773-533-7348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036038263261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care