| NPI | 1598245276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY A MENDEZ CEO 312-998-3940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2018-12-03 |