| NPI | 1063797108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREL A WALTON Owner 217-422-9740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IL 036082675) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2012-07-23 |