| NPI | 1053683474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMALUDDIN F AMANULLAH Sole Proprietor 309-349-3175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 136127585) |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2013-02-26 |