| NPI | 1720474885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE MYRLANDE KERNIZAN Owner 773-978-5291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036.099858) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2015-04-15 |