| NPI | 1396915955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISABETH I WALLNER President 312-926-0888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 36089720) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2012-05-08 |