| NPI | 1013177278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VARSHA BHAN Physician 708-669-1630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036098405) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2008-06-11 |