| NPI | 1700461514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMI JESTO JOSEPH Nurse Practitioner 773-677-3225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2021-03-12 |
| Last Update Date | 2021-03-12 |