| NPI | 1386796803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REA STAVROPOULOS LORENCE Owner 630-941-9344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 61509097) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2017-03-15 |