| NPI | 1699874255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE P NELSON Sole Proprietor 847-724-7825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: IL 036081181) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2008-01-28 |