NPI | 1538479456 |
---|---|
Entity Type | Organization |
Authorized Contact | FERNANDO REY URZUA President 630-469-4500 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 021002327) |
Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: IL 021002327) |
Enumeration Date | 2010-10-13 |
Last Update Date | 2010-10-13 |