| 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 |