| NPI | 1356759294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON DANIELS VP 815-966-2084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 2080P0202X Pediatrics Pediatric Cardiology | |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2018-07-12 |