| NPI | 1790182327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN J. ACIERNO Manager 630-339-3172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 019021636) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: IL 019028140) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2015-01-14 |