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 |