| NPI | 1598308702 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KARAN STAGGERS President 312-307-1295  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health | 
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2019-10-21 | 
| Last Update Date | 2019-10-21 |