| NPI | 1104348622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY LEE RUBAS General Counsel 312-465-7898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY TP057) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KY TP057) |
| 225100000X Physical Therapist (Licence: KY TP057) | |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2018-05-17 |