| NPI | 1922280296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISRAEL LABAO CEO 708-652-5423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 336040596 (36077467)) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2012-10-05 |