| 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 |