NPI | 1912066788 |
---|---|
Entity Type | Organization |
Authorized Contact | IRENE THOMAS-THEVATHERIL President 630-734-0580 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 036105417) |
Enumeration Date | 2006-12-07 |
Last Update Date | 2021-03-01 |