| NPI | 1912129735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELTON XAVIER TINSLEY President 312-222-0030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IL 36079325) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2009-01-07 |