| NPI | 1275068876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIAISHA YUTRINA WASHINGTON Advanced Nurse Practitioner 773-962-3975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: IL 209.015904) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2017-05-03 |