| NPI | 1043524614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDI L JEFFERS Practice Manager 708-957-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IL 042619353) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2014-04-01 |