NPI | 1093739435 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID TKACH CEO 217-545-7578 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
207V00000X Obstetrics & Gynecology | |
207VX0201X Obstetrics & Gynecology, Gynecologic Oncology | |
207VG0400X Obstetrics & Gynecology, Gynecology | |
207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine | |
207VX0000X Obstetrics & Gynecology, Obstetrics | |
207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology | |
Enumeration Date | 2006-07-27 |
Last Update Date | 2022-07-21 |