| NPI | 1881609287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD JOSEPH BODUCH Ms 847-884-9440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: IL 042007119) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2007-10-23 |