| NPI | 1306222070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNETTE MCROY Billing Coordinator 773-767-3822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036082067) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 036082067) |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2015-08-05 |