| NPI | 1124550421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANJIV LAKHANPAL CEO 815-254-1761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME125575) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-03-28 |