| NPI | 1891975512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA MAVASHEV Office Manager 773-271-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036101294) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2020-10-13 |