| NPI | 1144517830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORAWAN SUKAVACHANA President/CEO 847-650-1452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: IL 036085859) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2011-07-01 |