| NPI | 1104375518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA DONORIO CEO 847-749-2248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2016-09-26 |