| NPI | 1295274660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ELMORE President 773-398-6867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: CA A105818) |
| Enumeration Date | 2017-02-18 |
| Last Update Date | 2017-02-18 |