| NPI | 1619281482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLA AZAR Owner 773-334-6370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036121756) |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2010-09-06 |