| NPI | 1841419785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OCTAVIO M LOPEZ President 708-448-8899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: IL 036079369) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |