| NPI | 1184935405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN DAVIDSON Office Manager 847-367-8815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 7003144) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2010-07-01 |