| NPI | 1154478766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVE MANTE President 630-897-9606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: IL 042617613) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2011-02-03 |