| NPI | 1518180181 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | AUDREY J VAN OENE Office Manager 312-493-1236 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 03608859) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036088859) | 
| Enumeration Date | 2007-04-11 | 
| Last Update Date | 2007-08-17 |