| NPI | 1114991387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE M KOSOVA President 630-478-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2020-07-27 |