| NPI | 1780729145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY A KIRSCHBAUM Office Manager 847-869-6485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 042000228) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |