| NPI | 1174716823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER J NORDLOH CFO 708-747-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: IL 044) |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2022-07-21 |