| 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 |