| NPI | 1831475466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE MARIE EVERETT Physician Assistant 630-810-0777 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: IL 085004210) |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2011-10-27 |