| NPI | 1033310933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C FARMER Owner 773-375-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036051413) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2020-08-22 |