| NPI | 1124162136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARTRELL D KING Administrator Owner 773-505-6120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036056245) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036056245) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-08-22 |