| NPI | 1154974590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA OSIPOVA Owner 773-561-7911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology |
| Additional Taxonomies | 208600000X Surgery |
| 2086S0102X Surgery, Surgical Critical Care | |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2019-08-09 |