| NPI | 1811027808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARYN MELICHAR Billing Manager 708-423-2258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 042006686) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2012-06-19 |