| NPI | 1538379516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUMBERTO VERGARA President 773-278-4811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: IL 036-072013) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2010-08-31 |