| NPI | 1245781269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TABERNACKI President 708-601-2688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 046-008140) |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2016-10-14 |