| NPI | 1215938840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY COOMBS Billing Administrator 847-223-9494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2020-08-22 |