| NPI | 1154379543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDALL R. LUTZ Billing Manager 847-836-7015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2020-08-22 |