| NPI | 1972904282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN J ACIERNO Manager 630-339-3172 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 019021506) |
| Enumeration Date | 2014-09-07 |
| Last Update Date | 2014-09-07 |