| NPI | 1477747939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZA ROQUE Director 708-608-2195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology |
| 2088P0231X | |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2020-03-18 |