| NPI | 1083087696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMISH PATEL Owner 847-519-4701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085005650) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2015-11-04 |