| NPI | 1568690717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KOEHLER President 773-545-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 038-005194) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2009-06-30 |