| NPI | 1689776429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA JANO President 630-620-4364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 019.022565) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2020-08-22 |