| NPI | 1326562539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD WILLIAM WELLMAN Manager 309-287-7922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IL 036091292) |
| Enumeration Date | 2017-07-29 |
| Last Update Date | 2022-07-21 |