| NPI | 1699092429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN MANGUERRA Member/Owner 708-833-2412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036051511) |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2010-05-04 |