| NPI | 1205214103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA RICE Adminsitrator 773-752-6340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 036130154) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2021-08-11 |