| NPI | 1194910125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA M JACKSON Director Of Revenue 312-747-9443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2007-09-12 |