| NPI | 1710160130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA CVENGROS Physician 773-755-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 2083X0100X Preventive Medicine, Occupational Medicine | |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2008-03-31 |