| NPI | 1467442293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KURT JOHNSON Executive Director 708-915-6364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 207R00000X Internal Medicine | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| 207RH0003X Internal Medicine, Hematology & Oncology | |
| 207RI0011X Internal Medicine, Interventional Cardiology | |
| 207V00000X Obstetrics & Gynecology | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: IL 036-048841) | |
| 207Y00000X Otolaryngology (Licence: IL 036-108069) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 208M00000X Hospitalist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2020-09-24 |