| NPI | 1417370537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY PANOZZO Owner 309-428-7055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036090677) |
| Enumeration Date | 2014-01-24 |
| Last Update Date | 2016-05-06 |