| NPI | 1104202480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY GOODMAN President 224-231-4363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041366223) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-08-10 |