| NPI | 1275762106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONA ABDULLAH ALFARES Resident 312-823-7637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MI L1598766) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2009-07-13 |