| NPI | 1942306758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONITA M PEREZ Insurance Manager 312-939-4121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2008-05-13 |