| NPI | 1528153335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL T IVANKOVICH Owner 773-675-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: IL 036105713) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2013-05-08 |