| NPI | 1417235359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN CHANTELL COLLINS Authorization 312-262-2739 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 213E00000X Podiatrist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2022-03-07 |