| NPI | 1073022000 |
|---|---|
| Doing Business As | BJC MEDICAL GROUP OF ILLINOIS |
| Entity Type | Organization |
| Authorized Contact | JOHN T ELLENA Medical Director 314-996-7644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2022-07-21 |