| NPI | 1902802770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY DEUTSCH Administrator/Manager 773-777-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 042-000071) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2020-08-22 |