| NPI | 1316071715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY JOHN THOMAS Provider 708-429-5968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 37-1381196) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |