| NPI | 1861635906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA MCGASTER Billing Manager 708-335-1848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA G84220) |
| Enumeration Date | 2009-04-18 |
| Last Update Date | 2009-04-18 |