NPI | 1104134915 |
---|---|
Entity Type | Organization |
Authorized Contact | MAIMANAT NIZAM Physician 630-654-1021 |
Organization Subpart ? | No |
Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: IL 036-06-9635) |
Enumeration Date | 2010-09-15 |
Last Update Date | 2010-09-15 |