| NPI | 1184296972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL OWEN PHELPS President 312-888-5754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2021-12-20 |