NPI | 1255606778 |
---|---|
Doing Business As | LIFEFORCE MEDICAL INSTITUTE |
Entity Type | Organization |
Authorized Contact | MARK ROSENBLOOM Chief Medical Officer 773-649-4154 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: IL 036.085053) |
Enumeration Date | 2012-03-16 |
Last Update Date | 2012-03-16 |