| NPI | 1952583783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VISWANATHAM SUSARLA Physician 847-741-0026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2007-12-21 |