| NPI | 1083007710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHTESHAM HYDER Owner 815-914-1414 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 36112807) |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2015-03-04 |