| NPI | 1912368150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL C OKNER Owner 224-433-6553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2023-04-19 |