| NPI | 1962663914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARAH TAZEEN President 630-310-8503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036.118381) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 036.118381) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2008-12-03 |