| NPI | 1104195809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH HOLLY SAMUELSOHN President 847-795-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 042-619911) |
| Enumeration Date | 2011-12-26 |
| Last Update Date | 2019-04-26 |