| NPI | 1104291434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANAS HUSNI KHALIFEH Co Owner 630-670-8351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: IL 198001280) |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2015-12-11 |