| NPI | 1659700458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH BODIE GROSS Principal 847-840-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 309002422) |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2013-11-02 |