| NPI | 1992123004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BHAVANA VAIDYA Md 773-962-4025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: IL 036066303) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2020-06-30 |