| NPI | 1205933736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGUEL RUBIO OCHOA President 217-443-3866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036038717) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036038717) |
| Enumeration Date | 2006-09-19 |
| Last Update Date | 2020-08-22 |