| NPI | 1124355904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVONNE WICKLIFFE-JONES Credentialing Mgr 630-914-2417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2009-11-16 |
| Last Update Date | 2013-05-29 |