| NPI | 1205257797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA BRIDGEWATER Authorized Rep 847-255-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2013-12-30 |