| NPI | 1013215474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILES B. MIZOCK President 847-509-0547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IL 036-035966) |
| Enumeration Date | 2011-03-09 |
| Last Update Date | 2011-03-09 |