| NPI | 1336658848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL KANNANKERIL Founder And Sole Practitioner 312-834-3076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: IL 071008430) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2022-07-21 |