| NPI | 1750575940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA BOMBARD Billing Director 630-897-6851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: IL 036088055) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036085384) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2011-02-14 |