| NPI | 1245040799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYSSA DALE GORDON President 847-650-7235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-01-08 |