| NPI | 1497460489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA ADRANEDA Practice Manager 847-800-0957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| 104100000X Social Worker | |
| 101Y00000X Counselor | |
| 163WW0000X Registered Nurse Wound Care | |
| 261QH0100X Clinic/Center Health Service | |
| Enumeration Date | 2023-01-16 |
| Last Update Date | 2024-11-15 |