NPI | 1194808667 |
---|---|
Entity Type | Organization |
Authorized Contact | SCOTT ALLEN KALE President 847-674-7520 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 036055661) |
Enumeration Date | 2006-10-20 |
Last Update Date | 2008-01-18 |