| NPI | 1972807188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE R. PEMBERTON Office Manager 847-685-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209002279) |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2011-01-03 |