| NPI | 1780856757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIRO H PATINO President 312-405-1040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: IL 060.009595) |
| Enumeration Date | 2008-03-30 |
| Last Update Date | 2008-03-30 |