| NPI | 1639455173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCEE A. BRUMMEL Executive Director 630-978-4915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-115418) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: IL 036-115418) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: IL 036-115418) | |
| Enumeration Date | 2011-10-28 |
| Last Update Date | 2018-02-21 |