| NPI | 1336456904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JACOB MAGIDOW Medical Director 847-347-7236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 036124533) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2011-05-30 |