| NPI | 1487920252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA M PETERSON Office Manager 708-799-5420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IL 36-048096) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2012-03-27 |