| NPI | 1134801350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADONNA PRINCE Director 217-317-6222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 207VC0300X Obstetrics & Gynecology, Complex Family Planning |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2023-11-16 |