NPI | 1184189672 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES EDWARD BECKETT Medical Director 708-341-6707 |
Organization Subpart ? | No |
Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
Enumeration Date | 2019-02-08 |
Last Update Date | 2019-02-08 |