| NPI | 1306987896 |
|---|---|
| Other Name | MIDWEST UROLOGY-EVERGREEN PARK |
| Entity Type | Organization |
| Authorized Contact | ELIZA ROQUE Director 708-608-2195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2020-03-18 |