| NPI | 1760561971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES S COLODNY President 847-362-1393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036057093) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036043498) |
| 207Q00000X Family Medicine (Licence: IL 036093881) | |
| 207Q00000X Family Medicine (Licence: IL 036100943) | |
| 207Q00000X Family Medicine (Licence: IL 036090215) | |
| 207Q00000X Family Medicine (Licence: IL 036114414) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-08-22 |