| NPI | 1609297266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERRY CAMMISA Manager 630-817-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036134622) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038006843) |
| 207P00000X Emergency Medicine (Licence: IL 03607713) | |
| 208VP0000X (Licence: IL 036089214) | |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2015-02-06 |