| NPI | 1851898167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES EDWARD GONZALES Owner 708-705-3772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: IL 238-000536) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2018-05-02 |