NPI | 1104064260 |
---|---|
Entity Type | Organization |
Authorized Contact | VICENTE EUGENIO CARDENAS President 773-247-8855 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036103295) |
Enumeration Date | 2009-01-28 |
Last Update Date | 2009-01-28 |