NPI | 1134502891 |
---|---|
Entity Type | Organization |
Authorized Contact | MEREDITH BARNES INGRAM Owner/President 312-640-0002 |
Organization Subpart ? | No |
Primary Taxonomy | 251X00000X (Licence: IL 100693939) |
Additional Taxonomies | 251X00000X (Licence: IL 9691210) |
Enumeration Date | 2015-06-30 |
Last Update Date | 2016-01-04 |