| NPI | 1235467903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOLORES LOUISE DIXON-GREVIOUS President 312-850-3855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 036100552) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: IN 01060010A) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2009-11-18 |