| NPI | 1629956552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY M DELIZO Director Of Operations 773-977-2101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2025-08-27 |
| Last Update Date | 2025-09-23 |