| NPI | 1912448085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE ENEOGWE Owner 773-680-7388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-007655) |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2017-03-09 |