| NPI | 1003449612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUSEUN OSINOWO Member 773-997-8757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2021-07-26 |