| NPI | 1053404640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY J PETRONE CEO 847-885-8820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-103275) |
| Additional Taxonomies | 111NX0800X Chiropractor, Orthopedic (Licence: IL 042617415) |
| 208D00000X General Practice (Licence: IL 1679510804) | |
| 363L00000X Nurse Practitioner | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2011-10-25 |