| 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 |