| NPI | 1023380524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN W KOLB Medical Director 847-438-2144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 042619901) |
| Enumeration Date | 2012-01-31 |
| Last Update Date | 2012-01-31 |