| NPI | 1710126032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZA ROQUE Director 708-608-2195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: IL 036-120732) |
| Additional Taxonomies | 208800000X Urology (Licence: IL 036-102534) |
| 2088P0231X (Licence: IL 036-062338) | |
| 208800000X Urology (Licence: IL 036-094573) | |
| 208800000X Urology (Licence: IL 036-257763) | |
| 208800000X Urology (Licence: IL 036-096031) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: IL 036-076990) | |
| Enumeration Date | 2009-02-10 |
| Last Update Date | 2020-03-18 |