| NPI | 1720021496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY L BUCKLES CEO 773-445-0292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207T00000X Neurological Surgery |
| 208000000X Pediatrics | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-08-22 |