| NPI | 1770667289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAOMI M CASSIN A VP, Provider Enrollment 312-724-8477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN OCD0000000001) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2022-12-14 |