NPI | 1376786277 |
---|---|
Entity Type | Organization |
Authorized Contact | ANTHONY J PISTERZI Director Of Residential Services 708-841-1071 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 003650) |
Enumeration Date | 2009-04-08 |
Last Update Date | 2009-04-08 |