| NPI | 1649691312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STUART BERNSEN CEO 847-912-2411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2013-12-26 |
| Last Update Date | 2014-02-05 |