| NPI | 1811524937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YAZEN JOUDEH Owner 708-904-4979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2020-03-26 |