| NPI | 1700129277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS G BALDOCEDA Owner 847-813-6216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2014-04-17 |