NPI | 1932635083 |
---|---|
Entity Type | Organization |
Authorized Contact | SHAZIA DAUDI President 847-230-9808 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: IL 336072732) |
Enumeration Date | 2017-05-11 |
Last Update Date | 2022-11-08 |