NPI | 1881702942 |
---|---|
Entity Type | Organization |
Authorized Contact | ALEXANDER GARIBASHVILY President 847-962-9824 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036112246) |
Enumeration Date | 2006-08-29 |
Last Update Date | 2014-09-15 |