| NPI | 1285067298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA CATALINA VILLASENOR Owner 708-601-5081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: IL 019024012) |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2013-08-13 |