| NPI | 1134173917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE CHIARAVALLE Director 309-689-6049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208100000X Physical Medicine & Rehabilitation | |
| 208200000X Plastic Surgery | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2007-11-01 |