| NPI | 1396922688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH GLENN BOHLEN Owner/President 217-546-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036-069395) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2010-09-02 |