| NPI | 1043999642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADANNA C OKOLIE Director 708-271-3537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2023-07-12 |