| NPI | 1134185564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR ELOY Medical Director 217-233-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 7002983) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2013-04-01 |