| NPI | 1396081030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW WALKER CEO 847-910-2567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036060139) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038011342) |
| 171100000X Acupuncturist (Licence: IL 198001014) | |
| 208D00000X General Practice (Licence: IL 036112926) | |
| 363L00000X Nurse Practitioner (Licence: IL 209011079) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 041204674) | |
| Enumeration Date | 2012-12-28 |
| Last Update Date | 2013-12-18 |