| NPI | 1700337243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGIE JOHNSON Executive Director 773-651-3629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: IL 25812) |
| Additional Taxonomies | 251S00000X (Licence: IL 31898) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |