| NPI | 1760799126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELJUN L GOMEZ President 773-744-2935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209.008312) |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2010-09-08 |