| NPI | 1134343320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIBERATO D ALCALA Owner 815-725-0007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 0362779754) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 0366047016) |
| 208000000X Pediatrics (Licence: IL 0366091730) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |