| NPI | 1053503383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA P MADLA CEO 630-584-6127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 50783138) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2008-03-06 |