| NPI | 1902363443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN C COLLINS Authorized Official 312-262-2739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine | |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2022-02-02 |