| NPI | 1013313832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA SMITH Executive Administrative Assistant 217-547-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IL 042007969) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 042007969) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2020-11-06 |