| NPI | 1306014469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK BOWEN President 312-475-5536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085.003152) |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2008-02-12 |