| NPI | 1659564292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIAYONA TORRES Billing Director 219-756-3988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 36099650) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: IL 036099650) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2013-08-02 |