| NPI | 1235421603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG BACKS Owner/Physician 217-321-1987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 248000028) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2011-05-04 |