Provider Demographics
NPI:1750746681
Name:SOUTHWEST URGENT CARE LTD
Entity type:Organization
Organization Name:SOUTHWEST URGENT CARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HANAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-200-6615
Mailing Address - Street 1:8790 W 103RD ST
Mailing Address - Street 2:
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-1603
Mailing Address - Country:US
Mailing Address - Phone:708-200-6615
Mailing Address - Fax:708-598-3304
Practice Address - Street 1:2955 W 95TH ST
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2409
Practice Address - Country:US
Practice Address - Phone:708-200-6615
Practice Address - Fax:708-598-3304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty