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 |