| NPI | 1427225044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BHARAT GOPAL Program Director 217-383-3302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125-050-441) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-05-13 |