| NPI | 1073208856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN JOSEPH STROHL Authorized Official 312-489-6756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-04-07 |
| Last Update Date | 2025-10-07 |