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 |