| NPI | 1346698602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAQBOOL AHMAD President 618-993-5686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 7003143) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2016-05-27 |