| NPI | 1760815922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDO OBA SILVA President 224-558-9705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL P13000057299) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: FL P13000057299) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2013-08-12 |