| NPI | 1366294811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FNU MOHAMMED MUQTADIR President 224-341-5331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2024-04-05 |
| Last Update Date | 2025-12-19 |