| NPI | 1003959933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLAN J OLTHOFF President 312-623-3007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: IL 036064582) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2008-07-31 |