| NPI | 1134540446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY TASIGCHANA Nurse Practitioner 224-381-7672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 209.009079) |
| Enumeration Date | 2014-01-04 |
| Last Update Date | 2020-12-30 |