| NPI | 1245278233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELY ROBERT TANDETER Owner 773-235-6266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2013-07-26 |