| NPI | 1336159961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN VINCENT President & CEO 708-216-3215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2023-08-23 |