| NPI | 1861943888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES A IDA Practice Owner 773-293-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 036.132972) |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2020-04-20 |