| NPI | 1255778221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS NORDLOH CFO 708-747-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2013-05-30 |