| NPI | 1528114501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN URSO Medical Billing Manager 773-763-3445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X (Licence: IL 036109990) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: IL 036063941) |
| 208C00000X Colon & Rectal Surgery (Licence: IL 036071149) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2007-12-21 |