NPI | 1760408439 |
---|---|
Entity Type | Organization |
Authorized Contact | MARGIE JOHNSON Executive Director 773-651-3828 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 261QP2300X) |
Enumeration Date | 2006-07-14 |
Last Update Date | 2011-10-20 |