| NPI | 1578068524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE BATTLES Billing Director 708-669-9314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-03-29 |