| NPI | 1902844400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN A MACK President 847-337-1396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 060008633) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2008-09-18 |