| NPI | 1053646927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DIETZ TETIK President 630-962-0474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: IL 036-44365) |
| Enumeration Date | 2009-10-12 |
| Last Update Date | 2013-04-08 |