| NPI | 1295950517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE L. MEDINA CEO And Medical Director 773-775-7540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 036048770) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2010-11-24 |