| NPI | 1700199841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INDU M VENCE President 847-466-5091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036096196) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2012-02-29 |