| NPI | 1245218411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SREENIVAS CHINTALAPANI Administrator Medical Director 309-277-5624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: IL 7003125) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2011-08-30 |