| NPI | 1124556444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANIA KHAMOO Administrator 773-309-6740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01077720A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 1952663593) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2018-03-17 |