| NPI | 1760821839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMER RUSTUM Owner 773-283-1802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036083101) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036044669) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2013-06-21 |