| NPI | 1447381074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON CAREY CFO 847-608-1344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2021-05-27 |