| NPI | 1700648607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN DOMER Billing Manager 312-288-6420 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology |
| Enumeration Date | 2024-01-25 |
| Last Update Date | 2024-01-29 |