| NPI | 1861660326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK RAUSER President 773-301-6144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 071007218) |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2008-02-18 |