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 |