| NPI | 1578841177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR MUNOZ Manager 773-450-1952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036119790) |
| Enumeration Date | 2011-07-30 |
| Last Update Date | 2012-08-28 |