| NPI | 1043763261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNIL AYYAGARI Medical Director 309-472-6669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME 97865) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |