| NPI | 1992811178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY R. VANCAUWELAERT President 773-506-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036092385) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: IL 036092385) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2010-02-19 |