| NPI | 1215960992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN ODELL Board Member 847-519-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: IL 1756908) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2022-07-29 |