| NPI | 1639797525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICE HARRELL JOHNSON Owner/Provider 312-394-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2020-07-24 |