| NPI | 1366205122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES A JOSEPH Owner 773-802-1177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-07-17 |