| NPI | 1205345337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAJUANA D. JOHNSON Owner, Manager 630-901-2879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 209008594) |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy (Licence: IL 209008594) |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2017-09-20 |