| NPI | 1487910220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA ANN GROLLO Business Manager 847-362-2311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036057324) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2012-04-05 |