NPI | 1164698536 |
---|---|
Entity Type | Organization |
Authorized Contact | JACK W LENOX President 815-965-6644 |
Organization Subpart ? | No |
Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: IL 036068164) |
Enumeration Date | 2008-05-05 |
Last Update Date | 2008-05-06 |