NPI | 1063996239 |
---|---|
Entity Type | Organization |
Authorized Contact | GRAINNE MCKEOWN Provider 773-338-2309 |
Organization Subpart ? | No |
Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2018-09-24 |
Last Update Date | 2019-03-15 |