| NPI | 1972016723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TETYANA VORONKINA Billing Manager 847-924-6621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: IL 036065434) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2018-08-24 |