| NPI | 1033507249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEMALI SHAH CEO 224-803-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2015-03-11 |