| NPI | 1114107422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAKUL K PANDYA Owner 815-741-2301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036054898) |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2007-11-05 |