| NPI | 1790043933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMIRA MENDOZA Credentialing Manager 630-628-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036094253) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2012-04-25 |