NPI | 1073208856 |
---|---|
Entity Type | Organization |
Authorized Contact | KEVIN JOSEPH STROHL Authorized Official 312-489-6756 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
Enumeration Date | 2023-04-07 |
Last Update Date | 2025-07-17 |