| NPI | 1144652199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN B SCHWARTZ Medical Director 815-664-5367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0001X |
| Additional Taxonomies | 208800000X Urology |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2013-08-01 |