NPI | 1972215390 |
---|---|
Entity Type | Organization |
Authorized Contact | BORIS GUREVICH Officer 847-226-5503 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 363L00000X Nurse Practitioner |
Enumeration Date | 2022-12-16 |
Last Update Date | 2023-01-09 |