| NPI | 1104278357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE MARIE ANDERER Director Electrologist 815-469-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 220.000021) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2016-07-11 |