| NPI | 1881059863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY MARK DELIZO III Managing Director 224-601-0082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036130652) |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2019-10-29 |