| NPI | 1346571361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS MARK LUNA Clinic Director/President 1773-619-3611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: IL 038-010483) |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2010-05-12 |