| NPI | 1609868041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FORTUNEE MASSUDA Medical Director & CEO 773-752-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2009-11-23 |