| NPI | 1295906774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED J. HALLORAN Owner 847-506-1478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036081972) |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2024-01-17 |