| NPI | 1184505042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN BIRD Manager 630-364-8144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2025-09-09 |
| Last Update Date | 2025-10-07 |