| NPI | 1164917720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN SMITH Medical Director 312-259-8555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2018-06-26 |