| NPI | 1558746289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRINIVASULU CONJEEVARAM Physician 630-207-2557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2022-02-07 |