| NPI | 1417497033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA R JOAQUIN President 312-670-0819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: IL 036071319) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-04-27 |