| NPI | 1124039391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE SPIELMAN Operations Manager 815-316-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: IL 042-617984) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 042-617984) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 042-617984) | |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 042-617984) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2008-08-06 |