| NPI | 1760544514 |
|---|---|
| Former Legal Business Name | SAINT THERESE PHYSICIANS ASSOCIATION |
| Entity Type | Organization |
| Authorized Contact | JOSEPH LIBERATORE Director 847-360-2445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-08-22 |