Provider Demographics
NPI:1972886612
Name:FIRST CHOICE CHICAGO, LLC
Entity type:Organization
Organization Name:FIRST CHOICE CHICAGO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-938-5238
Mailing Address - Street 1:9999 W ROOSEVELT RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-2775
Mailing Address - Country:US
Mailing Address - Phone:708-938-5238
Mailing Address - Fax:708-938-5239
Practice Address - Street 1:9999 W ROOSEVELT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-2775
Practice Address - Country:US
Practice Address - Phone:708-938-5238
Practice Address - Fax:708-938-5239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-20
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy