| NPI | 1023207909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA G. CLARK Owner 847-269-9086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 041274227) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2008-06-23 |