| NPI | 1164820098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN C COLLINS Authorized Official 312-262-2739 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 213E00000X Podiatrist |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2022-02-02 |