| NPI | 1235186958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUDHA G PRASAD Doctor 217-546-4868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: IL 036079578) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2008-04-20 |