| NPI | 1366641524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN ROBERT BAYNE President 309-764-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 036-088102) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2007-07-17 |