NPI | 1407308752 |
---|---|
Entity Type | Organization |
Authorized Contact | ALEXANDER GREEN General Manager 847-494-0127 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2016-11-02 |
Last Update Date | 2016-11-02 |