| NPI | 1215327101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS TARA BULAON DELOS REYES President 773-742-3941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036130229) |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2015-01-29 |