| NPI | 1679842470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTUONYE EZERIBE ONYEWUCHI Medical Director 312-550-2586 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 036118945) |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2011-12-27 |