| NPI | 1306177720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAHMA R KONDA President 309-792-6770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 036-101548) |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2010-01-25 |