| NPI | 1962603472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANASTACIA R LARGOSA President 708-424-7705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036057514) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2008-06-17 |