NPI | 1295941573 |
---|---|
Entity Type | Organization |
Authorized Contact | TANIA M MIKAITIS President 312-404-0244 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209005514) |
Enumeration Date | 2007-05-15 |
Last Update Date | 2010-03-29 |