| NPI | 1235663782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BHAVIN CHANDRAKANT SHAH CEO/ President 815-582-3177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: IL 036.138823) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036.138823) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2018-03-17 |