| NPI | 1578634168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEKSANDR PODOLSKIY Medical Director 847-918-0430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036111753) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2013-05-14 |