| NPI | 1154379485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA ELLIS Authorized Official 312-942-6644 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2011-05-03 |