NPI | 1225583776 |
---|---|
Entity Type | Organization |
Authorized Contact | ALAN J ACIERNO Manager 630-339-3172 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 019018378) |
Enumeration Date | 2016-08-24 |
Last Update Date | 2016-08-24 |