Provider Demographics
NPI:1871738591
Name:FIRST AID CLINIC LLC
Entity type:Organization
Organization Name:FIRST AID CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTONIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-894-4591
Mailing Address - Street 1:7742 W HIGGINS RD # C102
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3353
Mailing Address - Country:US
Mailing Address - Phone:773-594-2431
Mailing Address - Fax:
Practice Address - Street 1:7742 W HIGGINS RD # C102
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3353
Practice Address - Country:US
Practice Address - Phone:773-594-2431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty