| NPI | 1124212576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURENCE HOGSTROM Internal Medicine 773-878-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036064677) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036105797) |
| 207R00000X Internal Medicine (Licence: IL 036064677) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2007-08-29 |