| NPI | 1043496433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY EUGENE CROVETTI President/CEO 708-502-3433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: IL 036096721) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036096721) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: IL 036096721) | |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2008-02-08 |