| NPI | 1659394229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PREMA DAVID Advanced Practice Nurse 312-864-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 209-000941(41-192393) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-22 |