| NPI | 1295858629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE JOHN BULYAKI President 773-275-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: IL 042617976) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |