| NPI | 1881859197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT J KARSTEN Doctor/Owner 847-717-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: IL 019027105) |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2008-07-25 |