| NPI | 1689619751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE BASS-JORDAN Executive Director 708-351-4895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2008-06-12 |