| NPI | 1205431368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINAYA KRISHNA PUPPALA Chief Executive Officer 847-340-7215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2020-12-04 |