| NPI | 1902152846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STELLA MUNOZ Nurse Practitioner 630-279-4861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2400X Clinic/Center Prison Health (Licence: IL 209.004846) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2012-07-30 |