| NPI | 1043624752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILYSA DIAMOND Owner 708-613-4417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 36120184) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2023-08-02 |