| NPI | 1508141441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZA ICAYAN Program Director 847-570-2509 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125057831) |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2011-10-11 |