| NPI | 1962430041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMRA E LEWIS President 847-382-5080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IL 14D0868940) |
| Additional Taxonomies | 208800000X Urology |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2024-01-29 |