| NPI | 1982095071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE HARTZ Medical Director 773-637-0166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036051428) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2015-12-28 |