| NPI | 1700113545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCELA E CORRALES President 224-539-5883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2009-11-16 |
| Last Update Date | 2024-03-22 |