| NPI | 1487131934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ALLEN CEO 312-912-7008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: IL 7512-0001) |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2018-07-26 |