| NPI | 1407008998 |
|---|---|
| Other Name | GREEN DRAGONFLY |
| Entity Type | Organization |
| Authorized Contact | RICHARD L KELLER Medical Director 847-360-1019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL A27740001A) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2008-10-16 |