| NPI | 1205003522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN CHARLES BURLISON CEO 630-962-8277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 038011023) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |