| NPI | 1750171807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY LITTLE Authorized Rep 773-960-1202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-05-12 |