| NPI | 1922551100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA LEIGH FRAZELLE Apn 312-472-3678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: IL 209014038) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: IL 209014038) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |