| NPI | 1346324555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EZEQUIEL MENDEZ HUERTA President 773-523-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036089095) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |