| NPI | 1740499573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA POLYAKOV Billing Manager 847-897-5995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036060462) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |