NPI | 1821473919 |
---|---|
Entity Type | Organization |
Authorized Contact | MARTI G GROGAN Office Manager 773-721-4900 |
Organization Subpart ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085005506) |
Enumeration Date | 2015-07-30 |
Last Update Date | 2015-07-30 |