| NPI | 1710279666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYSYN CONTRERAS Director Of Quality Assurance 312-939-5090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2012-10-15 |