| NPI | 1649610478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINICK A. ANCO Owner/President 708-258-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 038011458) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2021-08-04 |