KEDZIE MEDICAL CLINIC INC NPI 1558593947

NPI Information

  • NPI: 1558593947
  • Provider Name: KEDZIE MEDICAL CLINIC INC
  • Classification: Family Medicine - 207QA0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Organization
  • Address: 262 N KEDZIE AVE
    CHICAGO, IL
    ZIP 60612
  • Phone: (847) 904-7500

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NPI Details

KEDZIE MEDICAL CLINIC INC is an adolescent medicine family medicine in Chicago, IL. The provider is a family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. KEDZIE MEDICAL CLINIC INC NPI is 1558593947. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

262 N KEDZIE AVE
CHICAGO, IL
ZIP 60612-869
Phone: (847) 904-7500

The provider's authorized official is Gohar Akopyan .
The authorized official title is Cmm and has the following contact phone number (847) 904-7500.

The enumeration date for this NPI number is 8/18/2009 and was last updated on 8/18/2009.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QA0000XFamily MedicineAdolescent MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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