| NPI | 1659602837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT TANNER President/CEO 847-608-1344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2010-01-27 |