| NPI | 1316006307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAN MINGH NGUYEN President 312-587-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 019021689) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2020-08-22 |