| NPI | 1427666866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY D PENDOLINO Managing Member 815-436-1191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2020-07-28 |