| NPI | 1760755268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WADAH ATASSI Medical Director 312-965-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 036-081178) |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2015-11-19 |