| NPI | 1780031674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE M AUREL Advanced Practice Nurse 773-391-2182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 209014166) |
| Additional Taxonomies | 251E00000X Home Health (Licence: IL 209014166) |
| 261Q00000X Clinic/Center (Licence: IL 209014166;) | |
| 261QH0100X Clinic/Center, Health Services (Licence: IL 209014166) | |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2016-05-20 |