| NPI | 1497851703 |
|---|---|
| Doing Business As | PRIMARY CARE JOLIET |
| Entity Type | Organization |
| Authorized Contact | MITI G SHAH Practice Manager 815-726-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 209005700) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2018-10-19 |