| NPI | 1447613989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN MANDREA Physician 847-298-1831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 036111710) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2016-04-01 |