NPI | 1851434658 |
---|---|
Former Legal Business Name | JACK D. CLEMIS, MD SC |
Entity Type | Organization |
Authorized Contact | JACK D CLEMIS Physician 312-938-4327 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: IL 036038421) |
Enumeration Date | 2007-02-14 |
Last Update Date | 2013-02-07 |