NPI | 1619404803 |
---|---|
Entity Type | Organization |
Authorized Contact | GOPAL N BHALALA Md 847-872-5911 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036-072139) |
Enumeration Date | 2017-05-18 |
Last Update Date | 2022-07-21 |