| NPI | 1922300086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE E. BRUNELLE President 847-465-0401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 36-097428) |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2011-01-05 |