| NPI | 1508049149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY PENDOLINO Managing Member 815-436-1191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2020-07-22 |