| NPI | 1568662682 |
|---|---|
| Doing Business As | WESTERN-FOSTER MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | OLEG IVANOV Administrator 773-784-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 036087467) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2008-06-18 |