| NPI | 1821268772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY G. FORDE Office Manager 312-988-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IL 036104040) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2009-01-06 |