| NPI | 1184602880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN BARBARA RIFE Physician Owner 708-873-1187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036077841) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2012-04-04 |