Lake Cicero Clinic, SC
Lake Cicero Clinic, SC provides Internal Medicine Physician services in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2012.
- Licensed in
- IL
- In the registry since
- 2012
Practice location Address checks out
4801 W Lake StChicago, IL 60644-2609 Not confirmed with CMS for 14 years — call before visiting
Phone: (773) 378-8100
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Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Internal Medicine Physician (primary) | Taxonomy 207R00000X · Licence 036085519 (IL) |
|---|
Record details
| NPI number | 1336498062 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Gurcharan Randhawa — Owner - Physician · (773) 378-8100 |
| Other names | Lake Cicero Clinic |
| NPI enumerated | September 10, 2012 |
| Last updated in NPPES | September 10, 2012 |
| Mailing address | 4801 W Lake St, Chicago, IL 60644-2609 |
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