| NPI | 1609056795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANUEL GARCIA DOMINGUEZ President 773-770-3409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 042618263) |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2007-11-06 |