| NPI | 1629181284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRA FENTON Owner 847-367-7340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 36110464) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: IL 36058893) |
| 363AM0700X Physician Assistant, Medical (Licence: IL 085001035) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2024-04-26 |