| NPI | 1821203720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOWARD LANG ALT President 312-642-0060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 36-45795) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2008-11-29 |