| NPI | 1497575641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARKE ELKADI Manager 312-428-0781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-10-14 |
| Last Update Date | 2024-10-15 |