| NPI | 1932355245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA E LOYA-FRANK Doctor 708-343-8512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 036086943) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2024-06-24 |