| NPI | 1598461469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY MIDDLETON Owner 312-399-7185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261Q00000X |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2023-02-02 |
| Last Update Date | 2023-02-02 |