| NPI | 1174130413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA BEAL Fnp 708-808-0540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251F00000X Home Infusion |
| 261QH0100X Clinic/Center, Health Services | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2021-09-30 |