NPI | 1780081315 |
---|---|
Entity Type | Organization |
Authorized Contact | ALAN J. ACIERNO Manager 630-339-3172 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 019013528) |
Additional Taxonomies | 305R00000X Preferred Provider Organization |
305R00000X Preferred Provider Organization (Licence: IL 019026827) | |
Enumeration Date | 2014-11-25 |
Last Update Date | 2015-01-14 |