| NPI | 1972296382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISOKEN OGBOMO Nurse Practitioner 312-451-6418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2023-05-31 |
| Last Update Date | 2023-09-01 |