| NPI | 1487050993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY WILKES CEO 773-437-7816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2015-08-14 |