| NPI | 1871895474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE E. MARTINEZ Owner 630-483-0665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 036099034) |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2010-12-02 |