| NPI | 1174992119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNETTE MCROY Billing Coordinator 773-767-3822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: IL 036082067) |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2015-09-21 |