| NPI | 1316904964 |
|---|---|
| Former Legal Business Name | GERALD LEVISAY MDSC |
| Entity Type | Organization |
| Authorized Contact | GERALD LEVISAY President 815-664-5367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: IL 042003689) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2020-08-03 |