| NPI | 1235307158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSECA WATSON Contracts And Credentialing Manager 630-572-8228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: IL C/A-0554-0001-A) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2020-07-21 |