| NPI | 1508157348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY DIANNE DEARINGER Medical Director 312-467-0678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 038-005791) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2011-04-27 |