| NPI | 1770199218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUBBA RAO DAGGUBATI Director 847-644-1399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2023-12-07 |