| NPI | 1164749594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCISCO AVALOS Medical Director 708-222-9193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036-114621) |
| Enumeration Date | 2010-04-25 |
| Last Update Date | 2010-12-04 |