| NPI | 1588859714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY J SMITH President 630-920-1260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 038009491) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2008-11-11 |