| NPI | 1649833161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTEFAN G ROY Md 773-577-2141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2019-04-19 |