| NPI | 1154713568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALDEMAR M NOWAK President 708-857-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 03608751) |
| Enumeration Date | 2015-02-22 |
| Last Update Date | 2015-02-22 |