| NPI | 1598931198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARISSA BERESTENKO President 773-271-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036101565) |
| Enumeration Date | 2008-05-03 |
| Last Update Date | 2008-05-03 |