| NPI | 1821401316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYON HENNESSEY Partner 630-782-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085005057) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2014-06-03 |