| NPI | 1063539641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA MARIE TURPIN Billing Manager 708-957-2993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 036055574) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |