| NPI | 1699930701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAT SORRENTINO Supervisor 708-709-6396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: IL 042001344) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: IL 042001344) |
| 207N00000X Dermatology (Licence: IL 042001344) | |
| 207Q00000X Family Medicine (Licence: IL 042001344) | |
| 207R00000X Internal Medicine (Licence: IL 042001344) | |
| 207U00000X Nuclear Medicine (Licence: IL 042001344) | |
| 207V00000X Obstetrics & Gynecology (Licence: IL 042001344) | |
| 207W00000X Ophthalmology (Licence: IL 042001344) | |
| 207X00000X Orthopaedic Surgery (Licence: IL 042001344) | |
| 207Y00000X Otolaryngology (Licence: IL 042001344) | |
| 208000000X Pediatrics (Licence: IL 042001344) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 042001344) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 042001344) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: IL 042001344) | |
| 208600000X Surgery (Licence: IL 042001344) | |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2008-07-29 |