NPI | 1699959262 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES R. HERRON President 312-291-9083 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 042002026) |
Enumeration Date | 2007-12-19 |
Last Update Date | 2011-08-19 |