| NPI | 1447276480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN J. NEWMAN Director Of Accounting 815-877-4848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: IL 060-005593) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2016-01-20 |