| NPI | 1285182147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIDA RAMIREZ COO 219-237-2079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01055919A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01055919A) |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2020-07-01 |