| NPI | 1396389417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLYN DENISE HIRSCH Advanced Practice Nurse 708-571-0490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2025-10-15 |