| NPI | 1578969671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRL F BUNZOL Administrator 847-394-3553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IL 209.011531) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-17 |