| NPI | 1619913522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA KUTKA Credentialing 847-719-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2024-01-08 |