| NPI | 1376886820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY JENKINS Billing Manager 312-953-0547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: IL 036117092) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2013-04-03 |