| NPI | 1396575163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA M HELTON Billing & Office Operations Manager 847-695-0484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2024-08-06 |
| Last Update Date | 2024-08-06 |