| NPI | 1346866373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE ELMER Manager, Credentialing And Risk Man 815-381-7431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2023-01-20 |