| NPI | 1255376489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JOSEPH POLAND President 847-918-9179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 042007050) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2020-08-22 |