| NPI | 1558808923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LOTT President 630-730-5506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: IL 036107431) |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-25 |