| NPI | 1790338358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMIEBERT FAMANAS Managing Director 847-530-5916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2024-10-23 |