| NPI | 1508071903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY CLARBOUR Member 708-955-8033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036099064) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 036099064) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: IL 036099064) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |