| NPI | 1023253630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA M MAHMOOD President 773-465-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209006095) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 263296680) |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2008-12-10 |