| NPI | 1154567378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS JACKSON Accounting Director 630-483-4743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 39198502) |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2008-12-17 |