| NPI | 1669247250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH BONACCORSI Chief Legal Officer 312-346-6599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2023-11-24 |
| Last Update Date | 2023-11-24 |