| NPI | 1215170246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDY C CHIOU President 309-495-0240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Additional Taxonomies | 208600000X Surgery |
| 2086S0129X Surgery, Vascular Surgery | |
| 2088P0231X | |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2020-06-16 |