| NPI | 1770739591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTHER CORPUZ CEO 312-829-6304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center Student Health |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2019-09-20 |