| NPI | 1649410887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY ROBERT SCHULTZ President/CEO 847-634-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 096001765) |
| Enumeration Date | 2009-02-28 |
| Last Update Date | 2009-02-28 |