| NPI | 1912199548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER GORODETSKY Co Owner 847-962-3207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036102337) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036096374) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2007-08-16 |