| NPI | 1174658694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES A RUNKE Medical Director 312-201-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 042.616731) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2012-11-01 |