| NPI | 1295023778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELISSA NASH Administrator 773-889-3341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036114331) |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2012-06-29 |