| NPI | 1841485901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINADOR L DAYON Sole Proprietor 708-307-3555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036052751) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2007-11-16 |