| NPI | 1740595198 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ABELARDO J JARAVA Medical Director 773-472-2936  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036086850)  | 
| Enumeration Date | 2010-08-10 | 
| Last Update Date | 2010-08-13 |