| NPI | 1871163600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT BURGESS CEO 847-952-7460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2021-08-02 |