| NPI | 1962648386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYEZAH MIR President 630-378-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036112854) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036089109) |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |