| NPI | 1003535881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NZUBE OKONKWO Owner 773-600-4675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2024-03-17 |