| NPI | 1255725974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH RUSS Owner/Physician 630-470-5737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 038.012764) |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2015-03-19 |