| NPI | 1548471535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVONNE WICKLIFFE-JONES Credentialing Mgr 630-914-2417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2013-03-20 |