| NPI | 1639241334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEEL PATEL Owner 847-932-1079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 42618924) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |