| NPI | 1457405300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHUNG S RIM Provider 847-854-5533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: IL 036083588) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2011-11-17 |