| NPI | 1366627721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY WILLIAM CROSSETTI President 847-605-0280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 021000711) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 019013958) |
| 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 137000202) | |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2008-01-04 |