| NPI | 1437357480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK C LEONG Medical Director 773-282-3115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036070436) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2020-10-20 |