| NPI | 1184144370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL L KRAGT President 847-305-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036-085227) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2022-07-21 |