| NPI | 1467628073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY M MUTUA Physician/Owner 773-994-5502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036062092) |
| Enumeration Date | 2008-05-03 |
| Last Update Date | 2009-04-03 |