| NPI | 1316756067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID NOSACKA Chief Financial Officer 618-641-5468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant Medical | |
| 363L00000X Nurse Practitioner | |
| 363LA2100X Nurse Practitioner Acute Care | |
| 363LA2200X Nurse Practitioner Adult Health | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-05-19 |