| NPI | 1710903539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM CAPOBIANCO Exec VP Finance 773-792-7425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-08-22 |