| NPI | 1093011702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | S. JOSEPH MAURICE Consultant 312-569-7271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: IL 036037238) |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2011-01-28 |