NPI | 1235769704 |
---|---|
Entity Type | Organization |
Authorized Contact | JASON CAREY CFO 847-608-1344 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2020-01-23 |
Last Update Date | 2020-01-23 |