| NPI | 1700180171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN TABACK President 773-209-5199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036-098343) |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2010-12-28 |