| NPI | 1235100066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ROY TREISTER Head Official 312-633-5866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 36042189) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 36057244) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2009-01-13 |