| NPI | 1568489300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD J MINGOLELLI Medical Director 708-535-6369 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 042-618622) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 042-618622) |
| 207R00000X Internal Medicine (Licence: IL 042-618622) | |
| 207V00000X Obstetrics & Gynecology (Licence: IL 042-618622) | |
| 208600000X Surgery (Licence: IL 042-618622) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2013-06-13 |