| NPI | 1932784006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY LYNN HANSON Nurse Practitioner 773-552-2465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-03-10 |
| Last Update Date | 2021-03-10 |