| NPI | 1235373853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN GANADEN BASCO President 773-533-3440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036055675) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-06-10 |