| NPI | 1134382716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA KACHEVAS Practice Administrator 309-277-1120 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: IL 14D0430674) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2008-07-03 |