| NPI | 1518291376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZAIGHAM ULLAH TAHIR President 262-564-0611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WI 45299-021) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036.102772) |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2009-09-28 |