| NPI | 1194446237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEG DUNTEMAN Credentialing 630-770-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2022-09-07 |