| NPI | 1467774661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK I FITZGERALD President 847-823-4161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 060009606) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: IL 060009606) |
| Enumeration Date | 2010-02-16 |
| Last Update Date | 2010-02-16 |