| NPI | 1962664268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESSA BENTON Advance Practice Nurse 773-776-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: IL 036-09434) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2008-06-27 |