| NPI | 1053417402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA SABLESAK Clinical Director 847-544-5880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QL0400X Clinic/Center, Lithotripsy | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2025-01-09 |