| NPI | 1275705394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUSTAVO A. PEDRAZA President 815-467-4114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036-076520) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2008-03-28 |