| NPI | 1164882056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCOS BARAJAS Executive Director 708-446-4102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SF0001X Clinical Nurse Specialist, Family Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 225100000X Physical Therapist | |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2016-03-04 |