| NPI | 1952957698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN ASSAM Treasurer 708-567-2053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 251B00000X Case Management | |
| 251E00000X Home Health | |
| 347E00000X Transportation Broker | |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2021-05-12 |