| 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 |