| NPI | 1891040838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER MARYNIUK Billing Manager 847-770-6043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036-074391) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2012-07-16 |