| NPI | 1679159529 |
|---|---|
| Doing Business As | SMG WENTWORTH |
| Entity Type | Organization |
| Authorized Contact | DEBORAH CAPUTO Manager 773-257-2905 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2021-03-22 |