| NPI | 1700010543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRIAM BERNSTEIN VP Of Administration 773-539-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: IL 39494861) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2009-05-07 |