| NPI | 1811214240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAVIER ENRIQUE FAJARDO President 312-919-5023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2010-04-25 |
| Last Update Date | 2010-06-30 |