| NPI | 1740585736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANDRA RATHOD Mdsc 773-793-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036059328) |
| Enumeration Date | 2011-01-21 |
| Last Update Date | 2011-01-21 |