| NPI | 1679743900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT YODER Owner/President 708-418-5505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: IL 038-007368) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2008-03-03 |