| NPI | 1609982990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVANS FIAKPUI Medical Director 708-841-1110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: IL 042005235) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-08-22 |