| NPI | 1508242629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BECKETT Manager 773-359-4757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036087374) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 036087374) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2019-02-19 |