| NPI | 1104471622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH CAPUTO Credentialing Manager 773-257-2905 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology Obstetrics |
| Enumeration Date | 2019-08-02 |
| Last Update Date | 2019-08-02 |