GABISA MEDICAL CHICAGO PLLC NPI 1821765140

NPI Information

GABISA MEDICAL CHICAGO PLLC is a community health clinic center in Chicago, IL. GABISA MEDICAL CHICAGO PLLC NPI is 1821765140. The provider is registered as an organization entity type.

The provider's business location address is:

4121 W NORTH AVE
CHICAGO, IL
ZIP 60639-205
Phone: (773) 697-8623
Fax: (888) 929-2371

The provider's authorized official is Marcelo Venegas-pizarro .
The authorized official title is Medical Director and has the following contact phone number (347) 524-1914.

The CLIA number assigned to this NPI record is 33D2236691 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/25/2021 and was last updated on 8/25/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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