| NPI | 1922066588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG DONALD EWERT President 312-922-3815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2022-07-21 |