NPI | 1982879573 |
---|---|
Entity Type | Organization |
Authorized Contact | LEOPOLCO L JURADO President/Medical Director 773-874-1666 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization |
Enumeration Date | 2008-04-24 |
Last Update Date | 2008-04-24 |