| NPI | 1467759993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELICA MATIAS Manager 847-833-3975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036063408) |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2011-02-18 |