| NPI | 1073917134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE J CASTELLANOS President 773-309-6740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036073558) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036074259) |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2014-10-20 |