| NPI | 1073677589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEY COWAN Office Administrator 312-726-7272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 036096668) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-08-22 |