| NPI | 1669739736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L FESSENDEN Owner 847-217-0105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine | |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2019-07-26 |