| NPI | 1942649421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERLIN KELSICK President 773-251-4625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist | |
| 104100000X Social Worker | |
| 207Q00000X Family Medicine | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 208100000X Physical Medicine & Rehabilitation | |
| 2083X0100X Preventive Medicine, Occupational Medicine | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 208600000X Surgery | |
| 2086S0129X Surgery, Vascular Surgery | |
| 208C00000X Colon & Rectal Surgery | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2013-06-18 |