| NPI | 1689406399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORTNEE ROBERSON COOPER Owner/Lead Physician 773-418-0860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-08-20 |