| NPI | 1952005902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MCCULLOUGH Manager 773-553-9648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-07-17 |