| NPI | 1073706685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS H BURNSTINE Sole Proprietor 224-628-1256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 036079533) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2011-08-03 |