| NPI | 1851404131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALMACIO CUSI Physician 773-247-2131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036054622) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IL 036054622) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |