| NPI | 1649463175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONRAD MAY Doctor 773-533-1417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: IL 207QA0505X) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2023-03-07 |