NPI | 1740515253 |
---|---|
Former Legal Business Name | FAMILY MEDICINE SPECIALISTS INCORPORATED |
Entity Type | Organization |
Authorized Contact | JASON BELLUCCI CFO 847-526-2151 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036083207) |
Enumeration Date | 2009-10-16 |
Last Update Date | 2024-10-09 |