| NPI | 1881181055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANIA KHAMOO Administrator 773-309-6740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2018-12-14 |