| NPI | 1780839407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN C BALVERDE President 708-544-9690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036046845) |
| Enumeration Date | 2008-11-21 |
| Last Update Date | 2008-11-21 |