| NPI | 1730482944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN KUNG Manager 708-957-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL n/a) |
| Enumeration Date | 2010-12-09 |
| Last Update Date | 2010-12-09 |