| NPI | 1952429359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA PULAK Billing Manager 630-315-3981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036067912) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |