| NPI | 1144686676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELTON XAVIER TINLEY Physician/Surgeon 312-222-0030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: IL 036079325) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |