| NPI | 1285025213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN J ACIERNO Manager 630-339-3172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 01905148) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: IL 019027347) |
| 305R00000X Preferred Provider Organization (Licence: IL 019018205) | |
| 305R00000X Preferred Provider Organization (Licence: IL 019016834) | |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2015-02-12 |