| NPI | 1306977970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLINE KREISL WILSON Owner 773-600-2601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: IL 041256041) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2010-05-06 |