| NPI | 1679892889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE SIDNEY WRIGHT Medical Director 773-777-2620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036065761) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IL 036065761) |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2010-05-27 |