| NPI | 1528162864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL I MAITAR Medical Director 773-583-7420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2020-08-22 |