| Organization Name: | RS HARTZ MD NAMPTP NEUROPATHY DR SC |
| NPI Number: | 1982095071 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RENEE HARTZ (MEDICAL DIRECTOR) |
| Mailing Address: | 715 Lake St Suite 900 Oak Park |
| State: | IL US |
| Postal Code: | 603011422 |
| Phone Number: | 7736370166 |
| Fax Number: | 7083865547 |
| NPI Enumeration Date: | 02/10/2015 |
| NPI Last Update Date: | 12/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 036051428 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |