| NPI | 1093119521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITA WILLIAMSON HARRIS President 773-548-4387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 3000974) |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2015-06-26 |