| NPI | 1710037452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY J PARRISH Administrator 847-213-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 7003118) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-08-22 |