NPI | 1053500801 |
---|---|
Entity Type | Organization |
Authorized Contact | THOMAS N PORTER Physician, President 847-367-1151 |
Organization Subpart ? | No |
Primary Taxonomy | 208800000X Urology (Licence: IL 036063816) |
Enumeration Date | 2007-10-17 |
Last Update Date | 2007-10-17 |