| NPI | 1629022058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENKATA A VALLURY CEO 773-284-8601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2008-05-02 |