| NPI | 1952099145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY THEUS Owner 630-631-6160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2024-10-10 |