| NPI | 1922348804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTA LONG Business Manager 708-798-8112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2013-02-28 |
| Last Update Date | 2013-02-28 |