| NPI | 1053500553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD KENT POGUE President 309-762-9711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036115817) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2007-10-19 |