Provider Demographics
NPI:1932352499
Name:INTEGRATIVE FAMILY HEALTH ASSOCIATES
Entity Type:Organization
Organization Name:INTEGRATIVE FAMILY HEALTH ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KORI
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-417-6022
Mailing Address - Street 1:1212 N LASALLE ST
Mailing Address - Street 2:1001
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-8027
Mailing Address - Country:US
Mailing Address - Phone:312-202-0774
Mailing Address - Fax:
Practice Address - Street 1:4727 WILLOW SPRINGS RD
Practice Address - Street 2:UNIT 3S/4S
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-6140
Practice Address - Country:US
Practice Address - Phone:630-417-6022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036116890261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care