| NPI | 1972798064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS MANUEL REYNES President 708-771-3471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 035081965) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2008-02-26 |