| NPI | 1962617258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YIHOODAH Y. GREEN Member 773-522-5540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 2084D0003X | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2008-04-20 |