| NPI | 1861513822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN GOODMAN Office Manager 847-984-6452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0800X Clinic/Center, Endoscopy (Licence: IL 42618258) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |