| NPI | 1104099324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH E CANZONA Owner 847-328-8899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 36064858) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2012-05-22 |