NPI | 1962875336 |
---|---|
Entity Type | Organization |
Authorized Contact | ADAM TILSON President/Co Owner 630-428-2299 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 038.011200) |
Enumeration Date | 2015-11-07 |
Last Update Date | 2021-01-18 |