| NPI | 1932200425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLYNE JEAN-PIERRE Officer 773-881-9250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036106656) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IL 036111618) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-08-22 |