| NPI | 1699075804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HECTOR LUIS FLORES President 773-278-2998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036090820) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036090820) |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2010-10-22 |