| NPI | 1508059155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAC HENRY SCOTT President 773-721-1150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 036-064368) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2015-07-27 |