| NPI | 1306032297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER JAMES GRANT Physician 708-524-1747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036108911) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2007-09-24 |