| NPI | 1275575706 |
|---|---|
| Former Legal Business Name | GASTROENTEROLOGY, LTD |
| Entity Type | Organization |
| Authorized Contact | MIKE SHADLEY Administrator 309-672-4980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 042006270) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2020-08-17 |