NPI | 1588918684 |
---|---|
Entity Type | Organization |
Authorized Contact | REGINA H ROCHA Doctor/Owner 773-697-4348 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: IL 319016492) |
Enumeration Date | 2012-10-29 |
Last Update Date | 2012-10-29 |