| NPI | 1821345208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE THOMAS AMPALLOOR President 773-292-4501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036105483) |
| Enumeration Date | 2012-08-05 |
| Last Update Date | 2021-09-11 |