| NPI | 1144712563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH GARDNER Business Director 309-662-6120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2018-06-21 |