Karla Johan Avila-Polanco
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Chicago, IL
NPI 1902500796 · NPPES record last updated Mar 28, 2023
Key facts
- NPI
- 1902500796
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 3665 N Broadway St
Chicago, IL 60613-4567 - Phone
- (773) 496-4433
- NPI assigned
- Mar 28, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clarity Clinic PLLC | Current |
Accepting new patients |
Locations
3665 N Broadway St
Chicago, IL 60613
Phone (773) 496-4433
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
3665 N Broadway St
Chicago, IL 60613-4567
Mailing address
4417 N Central Park Ave Apt 2F
Chicago, IL 60625-5968
Other providers in Chicago, IL
- Avi Vodnoy Wolf, LLC
- Avid Intimacy, LLC
- Avila Dental PC
- Ana Maria Avila Rodriguez
- Mary Ann Avila-Cantore
- Christopher Avila
- Hector David Avila
- Jeanette Avila
- Jennifer Avila
- John Avila
All providers in Chicago, IL · Student in an Organized Health Care Education/Training Program in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.