| NPI | 1215138219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA KUBILIUS Manager 708-429-1200 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2017-03-31 |