| NPI | 1467148775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIENA MEEK HALL Physician 224-636-2498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 163WL0100X Registered Nurse, Lactation Consultant |
| 174N00000X Lactation Consultant, Non-RN | |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2025-09-06 |