| NPI | 1245350040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT ANDRLE Director Managed Care 312-864-4649 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: IL 0005272) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2022-06-06 |