| NPI | 1689921777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOPE A GREEN Clinical Director 708-299-4378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 149007169) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2014-04-08 |