| NPI | 1740529510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELJUN GOMEZ Nurse Practitioner 773-883-3953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209008312) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2013-02-13 |