| NPI | 1033397674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER MARYNIUK Billing Office 847-770-6043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VI 1002) |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2008-02-06 |