| NPI | 1063693323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK CHODZEN President 773-745-0391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 203.000961) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2014-11-12 |