| NPI | 1609363191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT ANDRLE Director Of Managed Care 312-864-4649 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2019-01-09 |