| NPI | 1275818098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTINE R GREENWELL Office Manager 847-382-4406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: IL 036065375) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: IL 036091317) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2015-02-26 |