| NPI | 1285937060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JOSEPH MERTZ Business Manager 217-787-9540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 0036078693) |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2016-07-26 |