| NPI | 1467405985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH J NELSON Chief Executive Officer 708-747-7960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 42005377) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2007-12-10 |