| NPI | 1255573622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBY MANN Director 630-856-6884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2017-11-07 |