| NPI | 1639375637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BORIS GUREVICH Medical Director 847-520-8909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2007-10-02 |