| NPI | 1356055016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONAH MINK CEO 224-484-0499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-07-06 |