| NPI | 1124010202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAMIE T. MARTIN Business Office Manager 630-681-0640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 042617305) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2020-08-22 |