| NPI | 1194861286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER ALAN LUCERO Owner 847-397-1215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2009-01-12 |