| NPI | 1841306321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO ANNE LIGHTFOOT Billing/Medical Records/Credentiali 847-259-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2010-03-19 |