| NPI | 1013183706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PUSHPA K MAMTANI President 815-754-5010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036064091) |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2008-05-02 |