NPI | 1073978243 |
---|---|
Entity Type | Organization |
Authorized Contact | CHERISE ELMORE Medical Billing Manager 219-840-2297 |
Organization Subpart ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036047008) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036047008) |
Enumeration Date | 2015-12-15 |
Last Update Date | 2015-12-15 |