| 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 |