| NPI | 1801605332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL NGUYEN Physician 224-933-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology |
| Enumeration Date | 2024-12-30 |
| Last Update Date | 2025-04-16 |