| NPI | 1821256355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDE R DUVAL Owner/Physician 224-783-8975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 042.617773) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2010-08-04 |