| NPI | 1306105655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE MARIE RUPP Owner 630-318-3355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 00303608379601) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209006778) |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2012-08-03 |