NPI | 1982081055 |
---|---|
Entity Type | Organization |
Authorized Contact | NADA ZAYZAFOON Owner 312-919-6266 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 19026509) |
Enumeration Date | 2015-04-28 |
Last Update Date | 2015-04-28 |