| NPI | 1265142129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAGAN KANSAL Authorized Official 312-620-1803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2022-12-10 |